Shmuely Haim, Monely Lea, Shvidel Lev
Department of Internal Medicine D, Kaplan Medical Center, Rehovot 7612001, Israel.
Faculty of Medicine, Hebrew University, Jerusalem 9112001, Israel.
J Clin Med. 2023 Aug 29;12(17):5635. doi: 10.3390/jcm12175635.
Febrile neutropenia (FN) is one of the most important life-threatening complications in haemato-oncology. Our objective was to report all-cause mortality rates in patients ill with a hematological malignancy (HM) hospitalized with a first FN episode and to identify predictors for mortality. We conducted a historical retrospective cohort study of consecutive patients with an HM, >18 years of age, admitted between January 2012 and August 2018 for a first episode of FN. Data on all-cause mortality 12 months after admission for FN were obtained. The Kaplan-Meier curve was used to describe mortality during the follow-up period. Univariate and multivariable analyses identified predictors for 1,3 and 12-month mortality. One hundred and fifty-eight patients (mean age 69.5, 49.4% males) were included. Overall, 54 patients died (15.8%, 25.9%, and 34.1% died after 1, 3, and 12 months, respectively). Lower serum albumin, higher serum gamma-glutamyl transferase (GGT), lower estimated glomerular filtration rate (eGFR), older age, higher temperature, and lower absolute lymphocyte count at admission were independent predictors of all-cause mortality after 12 months. Further studies are needed to confirm our results and identify therapeutic strategies to improve survival.
发热性中性粒细胞减少症（FN）是血液肿瘤学中最重要的危及生命的并发症之一。我们的目的是报告首次发生FN并因血液系统恶性肿瘤（HM）住院的患者的全因死亡率，并确定死亡率的预测因素。我们对2012年1月至2018年8月期间因首次FN发作而入院的年龄>18岁的连续HM患者进行了一项历史性回顾性队列研究。获取了FN入院后12个月的全因死亡率数据。采用Kaplan-Meier曲线描述随访期间的死亡率。单因素和多因素分析确定了1、3和12个月死亡率的预测因素。共纳入158例患者（平均年龄69.5岁，男性占49.4%）。总体而言，54例患者死亡（分别在1、3和12个月后死亡的比例为15.8%、25.9%和34.1%）。入院时血清白蛋白水平较低、血清γ-谷氨酰转移酶（GGT）较高、估计肾小球滤过率（eGFR）较低、年龄较大、体温较高以及绝对淋巴细胞计数较低是12个月后全因死亡率的独立预测因素。需要进一步研究来证实我们的结果，并确定改善生存的治疗策略。
