Febrile Neutropenia: clinical and therapeutic characterization of patients treated in a national reference hospital.

Abstract

Febrile neutropenia (NF) is an oncological and infectious emergency secondary to chemotherapy that causes interruptions in treatment, increased morbidity, mortality and health costs in the management of cancer patients. Timely diagnosis and treatment is key to avoiding complications and death from NF. A descriptive cross sectional case series study was carried out in patients at the Manolo Morales Peralta Hospital, Nicaragua, during 2017-2021, with the objective of clinically and therapeutically characterizing 93 episodes of NF. The episodes mainly affect male patients 53.8%, with a mean age of 44 years and with the most frequent oncological diagnosis of Acute Lymphoid Leukemia. In 100% of the episodes, risk stratification was performed with the MASCC index (55.9% low risk) and the CISNE scale (77.4% intermediate risk). The classification of clinically documented infection 72% and skin/tissue focus 16.1% predominated. Culture was not performed in 71% of cases. The most frequent treatment was empirical 97.8%, ciprofloxacin was the most used drug. Targeted treatment was only applied to 7.5%, with Meropenem and Imipenem plus vancomycin being the most used therapeutic regimen. 68.8% of patients did not present complications, deaths associated with NF were recorded in 16.1% of patients.

Keywords: Febrile neutropenia, infections, haematology, cancer