Can Patients with Febrile Neutropenia Be Sent Home from the ED?

The Clinical Index of Stable Febrile Neutropenia score had 98% specificity and 98% positive predictive value in identifying low-risk emergency department patients.

The Multinational Association for Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores are used to risk-stratify patients with chemotherapy-induced febrile neutropenia. Low-risk patients are considered candidates for outpatient management. However, there has been little research on the scores' applicability in the emergency department (ED) setting.

Investigators retrospectively compared the two scores in 230 patients with chemotherapy-induced febrile neutropenia at two EDs. Fever was defined as temperature ≥38°C and neutropenia as absolute neutrophil count <1000 cells/µL. Adverse outcomes were upgrade in level of care, positive blood culture results, death, or clinical deterioration (acute organ f…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Can Patients with Febrile Neutropenia Be Sent Home from the ED?

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Reviewing Author