Medical Oncology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Department of Medicine, Peninsula Health, Frankston, Victoria, Australia.
Cancer Rep (Hoboken). 2021 Jun;4(3):e1345. doi: 10.1002/cnr2.1345. Epub 2021 Feb 26.
Febrile neutropenia is a serious complication of chemotherapy. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score identifies patients at low risk of serious complications. Outpatient management programs have been successfully piloted in other Australian metropolitan cancer centers.
To assess current management of febrile neutropenia at our regional cancer center and determine potential impacts of an outpatient management program.
We performed a retrospective review of medical records for all patients admitted at our regional institution with febrile neutropenia between 1 January 2016, and 31 December 2018. We collected information regarding patient characteristics, determined the MASCC risk index score, and if low risk, we determined the eligibility for outpatient care and potential reduction in length of stay and cost benefit.
A total of 98 hospital admissions were identified. Of these, 66 had a MASCC low-risk index score. Fifty-eight patients met the eligibility criteria for outpatient management. Seventy-one percent were female. The most common tumor type was breast cancer. Forty-eight percent were treated with curative intent. The median length of stay was 3 days. The median potential reduction in length of stay for each admission was 2 days. The total potential reduction in length of stay was 198 days. No admission resulted in serious complications.
This review demonstrates a significant number of hospital admission days can be avoided. We intend to conduct a prospective pilot study at our center to institute an outpatient management program for such low-risk patients with potential reduction in hospital length of stay. This will have significant implications on health resource usage, service provision planning, and patient quality of life.
发热性中性粒细胞减少症是化疗的严重并发症。多国癌症支持治疗协会（MASCC）风险指数评分可识别出发生严重并发症风险较低的患者。在其他澳大利亚大都市癌症中心已成功试行门诊管理计划。
评估我们地区癌症中心发热性中性粒细胞减少症的当前管理情况，并确定门诊管理计划的潜在影响。
我们对 2016 年 1 月 1 日至 2018 年 12 月 31 日期间在我院因发热性中性粒细胞减少症入院的所有患者的病历进行了回顾性审查。我们收集了患者特征信息，确定了 MASCC 风险指数评分，如果风险低，则确定是否有资格接受门诊治疗以及潜在的住院时间缩短和成本效益。
共确定了 98 例住院病例。其中，66 例 MASCC 低风险指数评分。58 例符合门诊管理条件。71%为女性。最常见的肿瘤类型是乳腺癌。48%为治愈性治疗。中位住院时间为 3 天。每次住院的潜在住院时间缩短中位数为 2 天。潜在的总住院时间缩短为 198 天。没有一例住院导致严重并发症。
该回顾性研究表明，可以避免大量住院日。我们计划在我院进行一项前瞻性试点研究，为这类低风险患者制定门诊管理计划，从而潜在地缩短住院时间。这将对卫生资源使用、服务提供计划和患者生活质量产生重大影响。
