Determination of the relationship between mortality and SOFA, qSOFA, MASCC scores in febrile neutropenic patients monitored in the intensive care unit

Autor: Sebnem Calik, Fusun Gediz, Tuğba Çetintepe, Oktay Bilgir, Serife Solmaz, Mehmet Can Ugur, Lutfi Cetintepe
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Inotrope
Male
Multivariate analysis
Organ Dysfunction Scores
medicine.medical_treatment
health care facilities
manpower
and services
law.invention
0302 clinical medicine
Hematological malignancy
law
Medicine
030212 general & internal medicine
Hospital Mortality
Aged
80 and over
Middle Aged
Prognosis
Intensive care unit
qSOFA score
Hospitalization
Intensive Care Units
Oncology
030220 oncology & carcinogenesis
SOFA score
Original Article
Female
medicine.symptom
Emergency Service
Hospital
Adult
medicine.medical_specialty
Adolescent
Critical Care
Febrile neutropenia
Clinical Decision-Making
03 medical and health sciences
Young Adult
Sepsis
Humans
Aged
Monitoring
Physiologic
Retrospective Studies
Mechanical ventilation
Chemotherapy
business.industry
Organ dysfunction
medicine.disease
Respiration
Artificial
Emergency medicine
business
Zdroj: Supportive Care in Cancer
ISSN: 1433-7339
0941-4355
Popis: Purpose Febrile neutropenia (FN) is a hematological emergency. It is challenging and confusing for the clinicians to make the decision of the febrile neutropenic patients under chemotherapy to be monitored at intensive care unit (ICU). The aim of this study was to define the factors supporting decision-making for the critical patients with febrile neutropenia. Methods The data of 60 patients, who were taken to the ICU while they were under treatment in the Hematology Clinic with a diagnosis of febrile neutropenia, were analyzed retrospectively, in order to identify clinically useful prognostic parameters. Results The ICU mortality rate was 80%. Mortality was significantly associated with higher sequential organ failure assessment score (SOFA), quick sequential organ failure assessment score (qSOFA), and hematological SOFA (SOFAhem) scores on admission. All cases having SOFA score 10 and above and qSOFA score 2 and above died. In multivariate analysis, qSOFA score was found to be statistically significant in predicting mortality in regard to ICU admission (p = 0.004). Conclusion Mortality of febrile neutropenic patients admitted to ICU is high. It would be appropriate to determine the extent of organ dysfunction instead of underlying disease, for making the decision of ICU admission. It should be noticed that the risk mortality is high for the FN cases with SOFA score 10 or above, qSOFA score 2 or above, and in need of mechanical ventilation and positive inotropic support; hence, early intervention is recommended. In our study, the most significant parameter in predicting ICU mortality was found to be qSOFA.
Databáze: OpenAIRE
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