1. A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia
- Author
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Jimenez Fonseca, Paula, Carmona-Bayonas, Alberto, Matos Garcia, Ignacio, Marcos, Rosana, Castanon, Eduardo, Antonio, Maite, Font, Carme, Biosca, Merce, Blasco, Ana, Lozano, Rebeca, Ramchandani, Avinash, Beato, Carmen, Martinez de Castro, Eva, Espinosa, Javier, Martinez-Garcia, Jeronimo, Ghanem, Ismael, Hernando Cubero, Jorge, Aragon Manrique, Isabel, Garcia Navalon, Francisco, Sevillano, Elena, Manzano, Aranzazu, Virizuela, Juan, Garrido, Marcelo, Mondejar, Rebeca, Angeles Arcusa, Maria, Bonilla, Yaiza, Perez, Quionia, Gallardo, Elena, del Carmen Soriano, Maria, Cardona, Merce, Sanchez Lasheras, Fernando, Jesus Cruz, Juan, Ayala, Francisco, Spanish Soc Med Oncology SEOM, and FINITE Investigators
- Subjects
0301 basic medicine ,Male ,Cancer Research ,sistema de registros ,humanos ,Comorbidity ,neutropenia febril ,Likelihood ratios in diagnostic testing ,estudios multicéntricos como asunto ,Pulmonary Disease, Chronic Obstructive ,risk prediction ,0302 clinical medicine ,nomogramas ,Neoplasms ,evaluación de riesgos ,Multicenter Studies as Topic ,Registries ,mediana edad ,neoplasias ,Likelihood Functions ,adulto ,Middle Aged ,Prognosis ,sensibilidad y especificidad ,pronóstico ,Oncology ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Predictive value of tests ,Female ,funciones de verosimilitud ,medicine.symptom ,Infection ,Adult ,Mucositis ,medicine.medical_specialty ,complications ,enfermedades cardiovasculares ,Infections ,Risk Assessment ,Sensitivity and Specificity ,nomogram ,03 medical and health sciences ,Clinical Index of Stable Febrile Neutropenia ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,hiperglucemia ,Febrile Neutropenia ,pruebas de valores predictivos ,Performance status ,seemingly stable patients ,business.industry ,Organ dysfunction ,infección ,Nomogram ,medicine.disease ,Surgery ,Nomograms ,030104 developmental biology ,Hyperglycemia ,Clinical Study ,CISNE ,business ,Febrile neutropenia - Abstract
Background: We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN). Patients and methods: The data from the FINITE study (n = 1133) and University of Salamanca Hospital (USH) FN registry (n = 296) were used to develop and validate this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups. Results: The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status >= 2, chronic obstructive pulmonary disease, chronic cardiovascular disease, mucositis of grade >= 2 (National Cancer Institute Common Toxicity Criteria), monocytes 0.1). The concordance index was 0.855 and 0.831 in each series. Risk group stratification revealed a significant distinction in the proportion of complications. With a >= 116-point cutoff, the nomogram yielded the following prognostic indices in the USH registry validation series: 66% sensitivity, 83% specificity, 3.88 positive likelihood ratio, 48% positive predictive value, and 91% negative predictive value. Conclusions: We have developed and externally validated a nomogram and web calculator to predict serious complications that can potentially impact decision-making in patients with seemingly stable FN.
- Published
- 2016