Predicting Bacteremia in Children With Cancer and Fever in Chemotherapy-induced Neutropenia: Results of the Prospective Multicenter SPOG 2003 FN Study.

Details

Serval ID
serval:BIB_71C50E3C28A1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predicting Bacteremia in Children With Cancer and Fever in Chemotherapy-induced Neutropenia: Results of the Prospective Multicenter SPOG 2003 FN Study.
Journal
Pediatric Infectious Disease Journal
Author(s)
Agyeman P., Aebi C., Hirt A., Niggli F.K., Nadal D., Simon A., Ozsahin H., Kontny U., Kühne T., Beck Popovic M., Leibundgut K., Bodmer N., Ammann R.A.
ISSN
1532-0987 (Electronic)
ISSN-L
0891-3668
Publication state
Published
Issued date
2011
Volume
30
Number
7
Pages
e114-e119
Language
english
Abstract
STUDY AIM:: To develop a score predicting the risk of bacteremia in cancer patients with fever and neutropenia (FN), and to evaluate its performance. METHODS:: Pediatric patients with cancer presenting with FN induced by nonmyeloablative chemotherapy were observed in a prospective multicenter study. A score predicting the risk of bacteremia was developed from a multivariate mixed logistic regression model. Its cross-validated predictive performance was compared with that of published risk prediction rules. RESULTS:: Bacteremia was reported in 67 (16%) of 423 FN episodes. In 34 episodes (8%), bacteremia became known only after reassessment after 8 to 24 hours of inpatient management. Predicting bacteremia at reassessment was better than prediction at presentation with FN. A differential leukocyte count did not increase the predictive performance. The reassessment score predicting future bacteremia in 390 episodes without known bacteremia used the following 4 variables: hemoglobin ≥90 g/L at presentation (weight 3), platelet count <50 G/L (3), shaking chills (5), and other need for inpatient treatment or observation according to the treating physician (3). Applying a threshold ≥3, the score-simplified into a low-risk checklist-predicted bacteremia with 100% sensitivity, with 54 episodes (13%) classified as low-risk, and a specificity of 15%. CONCLUSIONS:: This reassessment score, simplified into a low-risk checklist of 4 routinely accessible characteristics, identifies pediatric patients with FN at risk for bacteremia. It has the potential to contribute to the reduction of use of antimicrobials in, and to shorten the length of hospital stays of pediatric patients with cancer and FN.
Pubmed
Web of science
Create date
04/07/2011 12:01
Last modification date
20/08/2019 14:30
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