Meireles Ana M, Moço Leonardo M, Moreira Cláudia S, Brás Gil P, Santo Ana E, Mariz Mário
Department of Haematology and Bone Marrow Transplantation, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal.
Clinical Oncology Group, IPO Porto Research Centre (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal.
Porto Biomed J. 2024 Oct 14;9(5):266. doi: 10.1097/j.pbj.0000000000000266. eCollection 2024 Sep-Oct.
Acute myeloid leukemia (AML) treated with intensive chemotherapy carries a high risk of severe infection. The development of reliable assessment tools to promptly identify patients at risk of developing critical illness is essential to prevent delays in intensive care unit (ICU) admission. This study evaluated the accuracy of quick Sequential Organ Failure Assessment (qSOFA) score, National Early Warning Score (NEWS), and NEWS2 score in predicting ICU admission and sepsis-related mortality in this population. A retrospective analysis was conducted, including 365 episodes of febrile neutropenia in 126 patients. The results showed that all three scores-qSOFA, NEWS, and NEWS2-demonstrated good accuracy for all outcomes, with area under the receiver-operating characteristic curve values for sepsis-related mortality of 0.812, 0.858, and 0.848, respectively. In addition, the scores exhibited excellent accuracy in predicting ICU admission and the composite outcome of ICU admission or sepsis-related mortality. To our knowledge, this is the first study to evaluate the accuracy of NEWS in a population of patients with AML who did not undergo stem cell transplantation. These findings suggest that NEWS and NEWS2 are effective tools for identifying patients with AML at high risk of clinical deterioration during febrile neutropenia, supporting their use in clinical practice.
接受强化化疗的急性髓系白血病（AML）患者发生严重感染的风险很高。开发可靠的评估工具以迅速识别有发生危重症风险的患者对于防止重症监护病房（ICU）收治延误至关重要。本研究评估了快速序贯器官衰竭评估（qSOFA）评分、国家早期预警评分（NEWS）和NEWS2评分在预测该人群ICU收治及脓毒症相关死亡率方面的准确性。进行了一项回顾性分析，纳入126例患者的365次发热性中性粒细胞减少发作。结果显示，qSOFA、NEWS和NEWS2这三个评分对所有结局均显示出良好的准确性，脓毒症相关死亡率的受试者工作特征曲线下面积值分别为0.812、0.858和0.848。此外，这些评分在预测ICU收治以及ICU收治或脓毒症相关死亡率的复合结局方面表现出优异的准确性。据我们所知，这是第一项评估NEWS在未接受干细胞移植的AML患者人群中准确性的研究。这些发现表明，NEWS和NEWS2是识别发热性中性粒细胞减少期间有临床恶化高风险的AML患者的有效工具，支持它们在临床实践中的应用。
