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Description

Kuderer et al identified risk factors associated with inpatient mortality for an adult cancer patient with febrile neutropenia. These can help to identify a patient who may require more aggressive management and to make informed decisions about treatment options. The authors are from the University of Rochester, University of Washington, Duke University and Union College in Albany.


 

Patient selection: adult inpatient with cancer and febrile neutropenia

 

Comorbid conditions associated with an increased risk of mortality:

(1) lung disease

(2) liver disease

(3) renal disease

(4) cerebrovascular disease

(5) pulmonary embolism

 

The mortality rate increases with the number of comorbid diseases (multi-organ failure), especially if infection is documented as the cause of the fever.

 

Cause of the febrile neutropenia associated with increased mortality:

(1) gram-negative or gram-positive bacteremia

(2) invasive candidiasis

(3) invasive aspergillosis

 

Feature of the infection predisposing to increased mortality:

(1) hypotension

(2) pneumonia

 


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