Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia.
Intern Med J. 2011 Jan;41(1b):82-9. doi: 10.1111/j.1445-5994.2010.02339.x.
Utilization of risk-stratification tools in the setting of neutropenic fever is currently limited by inadequate knowledge and lack of awareness. Within this context, the approach to management of low-risk patients with neutropenic fever is inconsistent with the available evidence across many Australian treating centres. These clinical guidelines define and clarify an accepted standard of care for this patient group given the current evidence base. The Multinational Association for Supportive Care in Cancer risk index is presented as the preferred risk assessment tool for determining patient risk. Suitability of ambulatory care within specific patient populations is discussed, with defined eligibility criteria provided to guide clinical decision-making. Detailed recommendations for implementing appropriate ambulatory strategies, such as early discharge and outpatient antibiotic therapy, are also provided. Due consideration is given to infrastructural requirements and other supportive measures at a resourcing and operational level. An analysis of the relevant health economics is also presented.
中性粒细胞减少性发热的风险分层工具的使用目前受到知识不足和缺乏认识的限制。在这种情况下，许多澳大利亚治疗中心对低危中性粒细胞减少性发热患者的处理方法与现有证据不一致。这些临床指南针对这一患者群体，根据现有证据基础，明确并阐明了公认的护理标准。多学科癌症支持治疗协会风险指数被提出作为确定患者风险的首选风险评估工具。还讨论了在特定患者人群中进行门诊治疗的适用性，并提供了明确的入选标准来指导临床决策。还详细建议实施适当的门诊策略，如提前出院和门诊抗生素治疗。在资源和运营层面上，充分考虑了基础设施要求和其他支持措施。还对相关卫生经济学进行了分析。
