Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure

Background and objectives: Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of...

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Autores principales:	Inês RODRIGUES, Luísa NASCIMENTO, Ana Cláudia PIMENTA, Sara RAIMUNDO, Bebiana CONDE, Ana FERNANDES
Formato:	article
Lenguaje:	ZH
Publicado:	Chinese Anti-Cancer Association; Chinese Antituberculosis Association 2021
Materias:	febrile neutropenia first-line antibiotic failure lung neoplasms mortality Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/9bd8aa2930da41dda05db2004e1cf81f
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spelling	oai:doaj.org-article:9bd8aa2930da41dda05db2004e1cf81f2021-11-19T06:49:15ZNeutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure1009-34191999-618710.3779/j.issn.1009-3419.2021.102.36https://doaj.org/article/9bd8aa2930da41dda05db2004e1cf81f2021-11-01T00:00:00Zhttp://dx.doi.org/10.3779/j.issn.1009-3419.2021.102.36https://doaj.org/toc/1009-3419https://doaj.org/toc/1999-6187Background and objectives: Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of patients with LC in a pulmonology department, and (2) to determine associations between patient profiles, first-line antibiotic failure (FLAF) and mortality.  Methods: Retrospective observational case-series, based on the analysis of medical records of LC patients that required hospitalization due to chemotherapy-induced FN.  Results: A total of 42 cases of FN were revised, corresponding to 36 patients, of which 86.1% were male, with a mean age of 66.71±9.83 years. Most patients had a performance status (PS) equal or less than 1, and metastatic disease was present in 40.5% (n=17). Respiratory tract infections accounted for 42.9% (n=18) of FN cases, and multidrug-resistant Staphylococcus aureus was the most isolated agent. The mortality rate was 16.7% (n=7), and the FLAF was 26.2% (n=11). Mortality was associated with a PS≥2 (P=0.011), infection by a Gram-negative agent (P=0.001) and severe anemia (P=0.048). FLAF was associated with longer hospitalizations (P=0.020), PS≥2 (P=0.049), respiratory infections (P=0.024), and infection by a Gram-negative (P=0.003) or multidrug-resistant agent (P=0.014).  Conclusions: Lower PS, severe anemia, and infections by Gram-negative or multi-resistant agents seem to be associated with worse outcomes in FN patients.Inês RODRIGUESLuísa NASCIMENTOAna Cláudia PIMENTASara RAIMUNDOBebiana CONDEAna FERNANDESChinese Anti-Cancer Association; Chinese Antituberculosis Associationarticlefebrile neutropeniafirst-line antibiotic failurelung neoplasmsmortalityNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ZHChinese Journal of Lung Cancer, Vol 24, Iss 11, Pp 764-769 (2021)
institution	DOAJ
collection	DOAJ
language	ZH
topic	febrile neutropenia first-line antibiotic failure lung neoplasms mortality Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	febrile neutropenia first-line antibiotic failure lung neoplasms mortality Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Inês RODRIGUES Luísa NASCIMENTO Ana Cláudia PIMENTA Sara RAIMUNDO Bebiana CONDE Ana FERNANDES Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
description	Background and objectives: Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of patients with LC in a pulmonology department, and (2) to determine associations between patient profiles, first-line antibiotic failure (FLAF) and mortality.  Methods: Retrospective observational case-series, based on the analysis of medical records of LC patients that required hospitalization due to chemotherapy-induced FN.  Results: A total of 42 cases of FN were revised, corresponding to 36 patients, of which 86.1% were male, with a mean age of 66.71±9.83 years. Most patients had a performance status (PS) equal or less than 1, and metastatic disease was present in 40.5% (n=17). Respiratory tract infections accounted for 42.9% (n=18) of FN cases, and multidrug-resistant Staphylococcus aureus was the most isolated agent. The mortality rate was 16.7% (n=7), and the FLAF was 26.2% (n=11). Mortality was associated with a PS≥2 (P=0.011), infection by a Gram-negative agent (P=0.001) and severe anemia (P=0.048). FLAF was associated with longer hospitalizations (P=0.020), PS≥2 (P=0.049), respiratory infections (P=0.024), and infection by a Gram-negative (P=0.003) or multidrug-resistant agent (P=0.014).  Conclusions: Lower PS, severe anemia, and infections by Gram-negative or multi-resistant agents seem to be associated with worse outcomes in FN patients.
format	article
author	Inês RODRIGUES Luísa NASCIMENTO Ana Cláudia PIMENTA Sara RAIMUNDO Bebiana CONDE Ana FERNANDES
author_facet	Inês RODRIGUES Luísa NASCIMENTO Ana Cláudia PIMENTA Sara RAIMUNDO Bebiana CONDE Ana FERNANDES
author_sort	Inês RODRIGUES
title	Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
title_short	Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
title_full	Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
title_fullStr	Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
title_full_unstemmed	Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure
title_sort	neutropenic fever in lung cancer: clinical aspects related to mortality and antibiotic failure
publisher	Chinese Anti-Cancer Association; Chinese Antituberculosis Association
publishDate	2021
url	https://doaj.org/article/9bd8aa2930da41dda05db2004e1cf81f
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Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure

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