ISSN: 1300-7777 E-ISSN: 1308-5263
Outcomes in 102 patients that present to the emergency department with chemotherapy-induced febrile neutropenia [Turk J Hematol]
Turk J Hematol. 2011; 28(3): 193-197 | DOI: 10.5152/tjh.2011.53  

Outcomes in 102 patients that present to the emergency department with chemotherapy-induced febrile neutropenia

Joo Han Lim1, Hoon Kim2, Woong Gil Choi3, Kyung Hwan Kim2, Dong Wun Shin2, Moon Hee Lee1
1Department Of Internal Medicine, Faculty Of Medicine, Inha University, Incheon, Korea
2Department Of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
3Department Of Internal Medicine, Konkuk University Hospital, Chungju, Korea

OBJECTIVE: Febrile neutropenia (FN) is a major toxic responseto chemotherapy requiring prompt medical attention. There are a limited number of reports on clinical outcome in patients with FN that present to emergency departments.
METHODS: We retrospectively evaluated clinical manifestations, therapeutic outcomes, and risk factors for FN in 102 adult patients that presented to the emergency department between 1 January 2006 and 31 March 2009. FN was defined as a body temperature>38C and a neutrophil count >0.5109/L on the day of fever onset or the day after.
RESULTS: Mean age of the patients was 57 years. Mean absolute neutrophil count (ANC) was 436.8/mm3 (range: 0-1000/mm3). In all, 23 of the patients (22.5%) died due to complications related to FN. There were not a statistical difference in therapeutic outcome among tumor types, performance status, sex, depth of neutropenia, or time from emergency department presentationto initiation of antibiotic therapy.
Age was an important prognostic factor for therapeutic outcome. Mean age of fatal cases was 65 years versus 56 years for non-fatal cases (p=0.016). Bacteremia was noted in 19 patients, 10 (53%) of which died. The mortality rate was significantly higher in thepatients with blood culture-proven bacteria than in those whose blood culture yielded no organism (p=0.013).
CONCLUSION: FN patients that presented to the emergency department had a high mortality rate that increased with age. Given the increasing age of patients diagnosed with cancer as well as therapeutic interventions, the high mortality rate associated withchemotherapy-induced FN in elderly patients requires further study in order to reduce the risk of death.

Keywords: Neutropenia, fever, emergency department, chemotherapy


Joo Han Lim, Hoon Kim, Woong Gil Choi, Kyung Hwan Kim, Dong Wun Shin, Moon Hee Lee. Outcomes in 102 patients that present to the emergency department with chemotherapy-induced febrile neutropenia. Turk J Hematol. 2011; 28(3): 193-197

Corresponding Author: Hoon Kim, Korea


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