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Prognostic Value of Serum Procalcitonin Levels in Patients With Febrile Neutropenia Presenting to the Emergency Department
- Source :
- The Journal of Emergency Medicine. 60:641-647
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Various risk-stratification scores have been developed to identify low-risk febrile neutropenia (FN). The Multinational Association of Supportive Care in Cancer (MASCC) score is a commonly used validated scoring system, although its performance varies due to its subjectivity. Biomarkers like procalcitonin (PCT) are being used in patients with FN to detect bacteremia and additional complications. Objective Our objective was to compare the performance of MASCC score with PCT in predicting adverse outcomes in patients with FN. Methods This was a prospective observational study that included chemotherapy-induced FN in hematologic or solid malignancy. The MASCC score, PCT levels, and blood cultures were taken at the first point of contact, and patient treatment was managed according to routine institutional protocol. The primary outcome was mortality at 30 days. Results A total of 100 patients were recruited, of which 92 had hematologic malignancy and 8 had solid malignancy. Forty-six patients were classified as low risk by MASCC score (≥21). The PCT threshold, 1.42 ng/mL, was taken as a cutoff value, with area under the receiver operating characteristic curve (AUROC) of 0.664 (95% confidence interval [CI] –0.55 to 0.77) for predicting mortality. AUROC for MASCC was 0.586 (95% CI 0.462 to 0.711). Conclusions PCT is a useful marker with better prognostic efficacy than MASCC score in patients with FN and can be used as an adjunct to the score in risk-stratifying patients with FN.
- Subjects :
- medicine.medical_specialty
Antineoplastic Agents
Malignancy
Risk Assessment
Procalcitonin
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Neoplasms
Internal medicine
medicine
Humans
030212 general & internal medicine
Febrile Neutropenia
Receiver operating characteristic
business.industry
Emergency department
Prognosis
medicine.disease
Confidence interval
030220 oncology & carcinogenesis
Bacteremia
Emergency Medicine
Observational study
Emergency Service, Hospital
business
Febrile neutropenia
Subjects
Details
- ISSN :
- 07364679
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- The Journal of Emergency Medicine
- Accession number :
- edsair.doi.dedup.....34dc167094844f02672d2f88094779d8