Taj M, Nadeem M, Maqsood S, Shah T, Farzana T, Shamsi T S
Department of Clinical Hematology and Bone Marrow Transplantation, National Institute of Blood Disease and Bone Marrow Transplantation, ST 2/A Block 17 Gulshan e Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
Head of Clinical Laboratories, National Institute of Blood Disease and Bone Marrow Transplantation, ST 2/A Block 17 Gulshan e Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
Indian J Hematol Blood Transfus. 2017 Sep;33(3):355-360. doi: 10.1007/s12288-016-0730-7. Epub 2016 Oct 1.
The purpose of this study is to evaluate the association of MASCC score (Multinational Association for Supportive Care in Cancer Score) in patients with febrile neutropenia (as resultant treatment of hematological disorders) for risk assessment of morbidity and mortality.
Patients presenting with Febrile Neutropenia from November 2011 till December 2013 were enrolled in the study. Initially all patients were hospitalized and their MASCC score was calculated, however those with high risk stayed in hospital till full ANC recovery while low risk group was discharged earlier and keenly followed as out-patient while being on prophylactic oral antibiotics. The MASCC risk-index score was calculated and patients with risk score >21 were regarded as low-risk while <21 were labeled as high-risk.
On the basis of 226 febrile neutropenia patient 132(58.4 %) were categorized as low risk while 94(41.5 %) as high risk patients according to MASCC risk index score. In low risk group 123(93 %) had uncomplicated infection while 9(7 %) had complicated infections. There was no mortality documented in low risk group while eight patients died in high risk group.
In this study we correctly predicted outcome of 123(93 %) low risk group patients. The study had positive predictive value of 93 % with both sensitivity and specificity of 65 and 75 % respectively. The MASCC risk score is a valuable tool in determining the outcome in patients with febrile neutropenia.
本研究旨在评估发热性中性粒细胞减少症患者（作为血液系统疾病的治疗结果）的MASCC评分（癌症支持治疗多国协会评分）与发病和死亡风险评估之间的关联。
纳入2011年11月至2013年12月出现发热性中性粒细胞减少症的患者。最初，所有患者均住院并计算其MASCC评分，然而，高危患者住院直至中性粒细胞绝对值完全恢复，而低危组患者则较早出院，并在服用预防性口服抗生素期间作为门诊患者密切随访。计算MASCC风险指数评分，风险评分>21的患者被视为低危，<21的患者被标记为高危。
根据MASCC风险指数评分，在226例发热性中性粒细胞减少症患者中，132例（58.4%）被归类为低危患者，94例（41.5%）为高危患者。在低危组中，123例（93%）发生无并发症感染，9例（7%）发生并发症感染。低危组无死亡记录，而高危组有8例患者死亡。
在本研究中，我们正确预测了123例（93%）低危组患者的结局。该研究的阳性预测值为93%，敏感性和特异性分别为65%和75%。MASCC风险评分是确定发热性中性粒细胞减少症患者结局的有价值工具。
