Perron Thomas, Emara Mohamed, Ahmed Shahid
Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
BMC Health Serv Res. 2014 Apr 10;14:162. doi: 10.1186/1472-6963-14-162.
Febrile neutropenia is an oncologic emergency. The timing of antibiotics administration in patients with febrile neutropenia may result in adverse outcomes. Our study aims to determine time-to- antibiotic administration in patients with febrile neutropenia, and its relationship with length of hospital stay, intensive care unit monitoring, and hospital mortality.
The study population was comprised of adult cancer patients with febrile neutropenia who were hospitalized, at a tertiary care hospital, between January 2010 and December 2011. Using Multination Association of Supportive Care in Cancer (MASCC) risk score, the study cohort was divided into high and low risk groups. A multivariate regression analysis was performed to assess relationship between time-to- antibiotic administration and various outcome variables.
One hundred and five eligible patients with median age of 60 years (range: 18-89) and M:F of 43:62 were identified. Thirty-seven (35%) patients were in MASCC high risk group. Median time-to- antibiotic administration was 2.5 hrs (range: 0.03-50) and median length of hospital stay was 6 days (range: 1-57). In the multivariate analysis time-to- antibiotic administration (regression coefficient [RC]: 0.31 days [95% CI: 0.13-0.48]), known source of fever (RC: 4.1 days [95% CI: 0.76-7.5]), and MASCC high risk group (RC: 4 days [95% CI: 1.1-7.0]) were significantly correlated with longer hospital stay. Of 105 patients, 5 (4.7%) died & or required ICU monitoring. In multivariate analysis no variables significantly correlated with mortality or ICU monitoring.
Our study revealed that delay in antibiotics administration has been associated with a longer hospital stay.
发热性中性粒细胞减少是一种肿瘤急症。发热性中性粒细胞减少患者使用抗生素的时机可能导致不良后果。我们的研究旨在确定发热性中性粒细胞减少患者使用抗生素的时间及其与住院时间、重症监护病房监测和医院死亡率的关系。
研究人群包括2010年1月至2011年12月在一家三级护理医院住院的成年发热性中性粒细胞减少癌症患者。使用癌症多国支持治疗协会（MASCC）风险评分，将研究队列分为高风险组和低风险组。进行多变量回归分析以评估使用抗生素时间与各种结局变量之间的关系。
确定了105例符合条件的患者，中位年龄为60岁（范围：18 - 89岁），男女性别比为43:62。37例（35%）患者属于MASCC高风险组。使用抗生素的中位时间为2.5小时（范围：0.03 - 50小时），中位住院时间为6天（范围：1 - 57天）。在多变量分析中，使用抗生素时间（回归系数[RC]：0.31天[95%置信区间：0.13 - 0.48]）、已知发热源（RC：4.1天[95%置信区间：0.76 - 7.5]）和MASCC高风险组（RC：4天[95%置信区间：1.1 - 7.0]）与较长的住院时间显著相关。105例患者中，5例（4.7%）死亡和/或需要重症监护病房监测。在多变量分析中，没有变量与死亡率或重症监护病房监测显著相关。
我们的研究表明，延迟使用抗生素与较长的住院时间有关。
