A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman
Background: Febrile neutropenia, a critical concern in chemotherapy-treated oncology patients, demands swift and guideline-based management. This study evaluated guideline adherence and clinical outcomes in the management of febrile neutropenia in oncology patients in the emergency department (ED)....
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Current Medical Issues |
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| Online Access: | https://journals.lww.com/10.4103/cmi.cmi_120_24 |
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| author | Badar Al-Aamri Aisha AL Breiki Darpanarayan Hazra Talib Al-Aamri Manar Al-Shehi |
| author_facet | Badar Al-Aamri Aisha AL Breiki Darpanarayan Hazra Talib Al-Aamri Manar Al-Shehi |
| author_sort | Badar Al-Aamri |
| collection | DOAJ |
| description | Background:
Febrile neutropenia, a critical concern in chemotherapy-treated oncology patients, demands swift and guideline-based management. This study evaluated guideline adherence and clinical outcomes in the management of febrile neutropenia in oncology patients in the emergency department (ED).
Methods:
This retrospective study was conducted over 4 years. The primary focus was the evaluation of adherence to guidelines for patient disposition and clinical outcomes. Data were retrieved from the hospital’s electronic records, systematically organized, and analyzed.
Results:
A total of 121 febrile neutropenic cases were included in the study. Of these, 52.9% were classified as low risk, with 44.6% having hematological malignancies and 55.4% having solid malignancies. Most patients (89.3%) presented with active cancer, and the mean neutrophil count was 0.18. High-risk patients exhibited significantly higher rates of positive blood cultures (31.6% vs. 1.6%) and positive urine cultures (20.8% vs. 7.7%). Chest X-rays were positive in 5.5% of low-risk patients and 23.2% of high-risk patients. Fungal infection rates were 1.6% in low-risk patients and 29.8% in high-risk patients. Complications were more frequent in high-risk patients, including sepsis-induced hypotension in 6.3% of low-risk patients and 43.9% of high-risk patients. Deaths occurred in 21.1% of high-risk patients, and intensive care unit (ICU) admissions were 24.6% in the high-risk group, with no ICU admissions in the low-risk group. Binary logistic regression revealed that male patients had a 60% lower risk of guideline discordance than female patients (odds ratio [OR]: 0.400, 95% confidence interval [CI]: 0.180-0.891, P = 0.025), whereas diabetic patients had a 75% lower risk than nondiabetic patients (OR: 0.254, 95% CI: 0.069–0.934, P = 0.039).
Conclusion:
As expected, high-risk patients demonstrated greater illness severity than low-risk patients, with higher rates of admission, sepsis-induced hypotension, and mortality. |
| format | Article |
| id | doaj-art-394db8bb979e481f88ca82903236d1d8 |
| institution | Kabale University |
| issn | 0973-4651 2666-4054 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Current Medical Issues |
| spelling | doaj-art-394db8bb979e481f88ca82903236d1d82025-02-10T14:49:12ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542025-01-01231323810.4103/cmi.cmi_120_24A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in OmanBadar Al-AamriAisha AL BreikiDarpanarayan HazraTalib Al-AamriManar Al-ShehiBackground: Febrile neutropenia, a critical concern in chemotherapy-treated oncology patients, demands swift and guideline-based management. This study evaluated guideline adherence and clinical outcomes in the management of febrile neutropenia in oncology patients in the emergency department (ED). Methods: This retrospective study was conducted over 4 years. The primary focus was the evaluation of adherence to guidelines for patient disposition and clinical outcomes. Data were retrieved from the hospital’s electronic records, systematically organized, and analyzed. Results: A total of 121 febrile neutropenic cases were included in the study. Of these, 52.9% were classified as low risk, with 44.6% having hematological malignancies and 55.4% having solid malignancies. Most patients (89.3%) presented with active cancer, and the mean neutrophil count was 0.18. High-risk patients exhibited significantly higher rates of positive blood cultures (31.6% vs. 1.6%) and positive urine cultures (20.8% vs. 7.7%). Chest X-rays were positive in 5.5% of low-risk patients and 23.2% of high-risk patients. Fungal infection rates were 1.6% in low-risk patients and 29.8% in high-risk patients. Complications were more frequent in high-risk patients, including sepsis-induced hypotension in 6.3% of low-risk patients and 43.9% of high-risk patients. Deaths occurred in 21.1% of high-risk patients, and intensive care unit (ICU) admissions were 24.6% in the high-risk group, with no ICU admissions in the low-risk group. Binary logistic regression revealed that male patients had a 60% lower risk of guideline discordance than female patients (odds ratio [OR]: 0.400, 95% confidence interval [CI]: 0.180-0.891, P = 0.025), whereas diabetic patients had a 75% lower risk than nondiabetic patients (OR: 0.254, 95% CI: 0.069–0.934, P = 0.039). Conclusion: As expected, high-risk patients demonstrated greater illness severity than low-risk patients, with higher rates of admission, sepsis-induced hypotension, and mortality.https://journals.lww.com/10.4103/cmi.cmi_120_24absolute neutrophil countschemotherapycritical care oncologyfebrile neutropenianeutropenia |
| spellingShingle | Badar Al-Aamri Aisha AL Breiki Darpanarayan Hazra Talib Al-Aamri Manar Al-Shehi A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman Current Medical Issues absolute neutrophil counts chemotherapy critical care oncology febrile neutropenia neutropenia |
| title | A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman |
| title_full | A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman |
| title_fullStr | A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman |
| title_full_unstemmed | A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman |
| title_short | A Retrospective Observational Cohort Analysis of Oncology Patients with Febrile Neutropenia in the Emergency Department of a Tertiary Care Hospital in Oman |
| title_sort | retrospective observational cohort analysis of oncology patients with febrile neutropenia in the emergency department of a tertiary care hospital in oman |
| topic | absolute neutrophil counts chemotherapy critical care oncology febrile neutropenia neutropenia |
| url | https://journals.lww.com/10.4103/cmi.cmi_120_24 |
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