The role of serum albumin/globulin ratio in combination with prognostic risk indexes of febrile neutropenia.

Objectives: The aim of this study was to evaluate the effect of the serum albumin/globulin ratio (AGR) on the 30‐day mortality of febrile neutropenia (FEN). The second aim of the study was to evaluate the effect of the combination of the AGR with the Multinational Association for Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) risk indexes on 30‐day mortality of FEN. Methods: A retrospective study evaluating the effect of serum AGR, MASCC and CISNE scores on 30‐day FEN mortality. Results: A total of 137 FEN episodes in 120 patients were included in this study. Nineteen patients (14%) died within the first 30 days of FEN episodes. The 30‐day mortality rate was calculated as 4% in patients with high AGR and 23% in patients with low AGR (P =.002). According to the MASCC and CISNE risk scores, the mortality rates in low‐risk patients were 8% and 6%, respectively, and in the high‐risk group 22% and 29%, respectively (P =.024 vs P <.001). In the group of patients with MASCC <21 and CISNE ≥3, the 30‐day mortality rate was 7%, when the AGR was >1.13, and in those with AGR ≤1.13 mortality rate increased to 50% (P =.012). Conclusion: A low AGR in a patient with FEN was found to be associated with an increased risk of 30‐day mortality. Combining the AGR with MASCC and CISNE risk indexes might increase the predictive value of these scoring systems on 30‐day mortality. [ABSTRACT FROM AUTHOR]