Evaluation of Risk Factors for Mortality in Febrile Neutropenia

  • Sabahat Ceken Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Habip Gedik Department of Infectious Diseasesand Clinical Microbiology, Bakırkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey
  • Gulsen Iskender Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Meryem Demirelli Department of Infectious Diseases and Clinical Microbiology, Bafra State Hospital, Samsun, Turkey
  • Duygu Mert Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Goknur Yapar Toros Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Tugce Nur Yigenoglu Department of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Fevzi Altuntas Department of Hematology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Berna Oksuzoglu Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
  • Mustafa Ertek Department of Infectious Diseases and Clinical Microbiology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
Keywords: Febrile neutropenia, Hematologic malignity, solid tumor, mortality, invasive fungal infection

Abstract

Introduction: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN).

Methodology: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated.

Results: A total of 135 FEN episodes of 115 patients, who comprised of 72 (63%) patients with 89 FEN episodes due to hematologic malignancies (hemato-group) and 43 (37%) patients with 46 FEN episodes due to solid organ cancers (onco-group), were evaluated in the study. The median age was 47 years (range: 17-75 years) and 66 (57%) patients were male. A total of 12 patients (8.8%) died during 135 episodes of FEN including nine cases from hemato-group and three cases from onco-group. Those factors including a presence of pneumonia, advanced age, persistent fever despite an antimicrobial treatment, and need for mechanical ventilation in intensive care unit (ICU) with were determined as risk factors associated with mortality.

Conclusions: Morbidity and mortality are more common in patients with hematological malignancies compared to patients with solid organ cancers due to prolonged neutropenia. In case of persistent fever, an invasive fungal infection (IFI) should be kept in mind in patients with hematologic malignancies and then antifungal treatment should be initiated. Although a persistent fever is also common in patients with solid tumors, the necessity of antifungal therapy is rare due to the short duration of neutropenia.

Published
2020-08-31
How to Cite
1.
Ceken S, Gedik H, Iskender G, Demirelli M, Mert D, Yapar Toros G, Yigenoglu T N, Altuntas F, Oksuzoglu B, Ertek M (2020) Evaluation of Risk Factors for Mortality in Febrile Neutropenia. J Infect Dev Ctries 14:886-892. doi: 10.3855/jidc.12520
Section
Original Articles