In the management of febrile neutropenia; evaluation of the factors affecting the lenght of hospital stay

Abstract

Aim: Febrile neutropenia (FEN) is one of the most serious and commonly seen complications of patients receiving chemotherapy for a diagnosis of hematological malignancy. FEN is an emergency condition with mortality rates reaching 40% because of an increase in antimicrobial-resistant pathogens in particular. In a situation with such high mortality rates, parameters that can predict prognosis play an important role in the approach to the patient. The aim of this study was to investigate the parameters that could affect prognosis in the follow-up of FEN. Material and Methods: The study included 58 patients hospitalised in the Hematology Clinic with a diagnosis of FEN. The patients were evaluated in respect of the recorded demographic characteristics, blood group, MASCC score, hemogram, procalcitonin, C-reactive protein (CRP), Interleukin-6 (IL-6), D-dimer, fibrinogen, pre-albumin, albumin, HbA1c, anthropometric measurements and length of stay in hospital. Results: According to the statistical analysis results, patients with a length of hospital stay of ≥14 days were determined to have a significant decrease in the MASCC score and thrombocyte count and the procalcitonin, Il-6, D-dimer values and the number of antibiotics used were higher. No significant difference was determined between the groups in respect of the other parameters. Conclusion: In the management of febrile neutropenia, the most important points are the establishment of indications for hospitalisation, rapid and early recognition of a worsening status and intervention made in the right place at the right time. Parameters with prognostic benefit will help the clinician in decision-making.