Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure.
10.3779/j.issn.1009-3419.2021.102.36
- Author:
Inês RODRIGUES
1
;
Luísa NASCIMENTO
1
;
Ana Cláudia PIMENTA
1
;
Sara RAIMUNDO
1
;
Bebiana CONDE
1
;
Ana FERNANDES
1
Author Information
1. Pulmonology Department, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, Portugal.
- Publication Type:Journal Article
- Keywords:
Febrile neutropenia;
First-line antibiotic failure;
Lung neoplasms;
Mortality
- MeSH:
Aged;
Anti-Bacterial Agents/adverse effects*;
Female;
Hospitalization;
Humans;
Lung Neoplasms/drug therapy*;
Male;
Methicillin-Resistant Staphylococcus aureus;
Middle Aged;
Retrospective Studies
- From:
Chinese Journal of Lung Cancer
2021;24(11):764-769
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of patients with LC in a pulmonology department, and (2) to determine associations between patient profiles, first-line antibiotic failure (FLAF) and mortality.
METHODS:Retrospective observational case-series, based on the analysis of medical records of LC patients that required hospitalization due to chemotherapy-induced FN.
RESULTS:A total of 42 cases of FN were revised, corresponding to 36 patients, of which 86.1% were male, with a mean age of 66.71±9.83 years. Most patients had a performance status (PS) equal or less than 1, and metastatic disease was present in 40.5% (n=17). Respiratory tract infections accounted for 42.9% (n=18) of FN cases, and multidrug-resistant Staphylococcus aureus was the most isolated agent. The mortality rate was 16.7% (n=7), and the FLAF was 26.2% (n=11). Mortality was associated with a PS≥2 (P=0.011), infection by a Gram-negative agent (P=0.001) and severe anemia (P=0.048). FLAF was associated with longer hospitalizations (P=0.020), PS≥2 (P=0.049), respiratory infections (P=0.024), and infection by a Gram-negative (P=0.003) or multidrug-resistant agent (P=0.014).
CONCLUSIONS:Lower PS, severe anemia, and infections by Gram-negative or multi-resistant agents seem to be associated with worse outcomes in FN patients.
