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血液肿瘤伴发热性中性粒细胞减少症患者的全因死亡率及其预测因素

All-Cause Mortality and Its Predictors in Haemato-Oncology Patients with Febrile Neutropenia.

作者信息

Shmuely Haim, Monely Lea, Shvidel Lev

机构信息

Department of Internal Medicine D, Kaplan Medical Center, Rehovot 7612001, Israel.

Faculty of Medicine, Hebrew University, Jerusalem 9112001, Israel.

出版信息

J Clin Med. 2023 Aug 29;12(17):5635. doi: 10.3390/jcm12175635.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca6c/10489066/b39bbd17dd11/jcm-12-05635-g001.jpg

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