Department of Medical Oncology, Gazi University, Ankara, Turkey.
Department of Internal Medicine, Gazi University, Ankara, Turkey.
Support Care Cancer. 2021 Feb;29(2):1047-1053. doi: 10.1007/s00520-020-05587-7. Epub 2020 Jun 25.
The study was aimed to evaluate the effect of uric acid (UA) on the 30-day mortality of patients admitted to the tertiary referral hospital with a complaint of febrile neutropenia (FEN). The secondary aim was to evaluate the use of combining serum UA levels with the Multinational Association for Supportive Care in Cancer (MASCC) risk score.
A retrospective study in which the MASCC score and serum UA levels were used to evaluate the mortality risk within 30 days among patients with FEN.
A total of 118 FEN episodes were included in the study and 17 (14%) of these patients died. While this rate is 23% in the high-risk group according to the MASCC score, it is 7% in the low-risk group (p = 0.011). In multivariate analysis of the parameters that significantly affect the 30-day FEN mortality, MASCC risk score (OR, 4.28; CI 95% 1.19-15.39, p = 0.013) and having a level of serum UA > 7 mg/dL (OR, 4.46; CI 95% 1.19-15.38, p = 0.032) was significantly increased the risk of in 30-day mortality of FEN. The rate of 30-day mortality of FEN was 0% in patients with a low MASCC risk score and UA level compared with 50% in the high MASCC risk score and high UA level group, and the difference was statistically significant (p < 0.001).
Increased level of UA at the time of FEN diagnosis was independently associated with an increased rate of 30-day mortality of FEN. The combination of the MASCC risk score and serum UA level might thoroughly predict the 30-day mortality of FEN.
本研究旨在评估尿酸(UA)对因发热性中性粒细胞减少症(FEN)就诊于三级转诊医院的患者 30 天死亡率的影响。次要目的是评估联合使用血清 UA 水平和多国癌症支持治疗协会(MASCC)风险评分。
本研究采用回顾性研究,使用 MASCC 评分和血清 UA 水平评估 FEN 患者 30 天内的死亡风险。
共纳入 118 例 FEN 发作,其中 17 例(14%)患者死亡。虽然根据 MASCC 评分,高危组的死亡率为 23%,但低危组的死亡率为 7%(p=0.011)。在对显著影响 FEN 30 天死亡率的参数进行多变量分析时,MASCC 风险评分(OR,4.28;95%CI,1.19-15.39,p=0.013)和血清 UA 水平>7mg/dL(OR,4.46;95%CI,1.19-15.38,p=0.032)显著增加了 FEN 30 天死亡率的风险。低 MASCC 风险评分和 UA 水平的 FEN 患者 30 天死亡率为 0%,而高 MASCC 风险评分和高 UA 水平组的死亡率为 50%,差异有统计学意义(p<0.001)。
FEN 诊断时 UA 水平升高与 FEN 30 天死亡率升高独立相关。MASCC 风险评分和血清 UA 水平的联合使用可能更全面地预测 FEN 的 30 天死亡率。