Abstract
Background: Febrile neutropenia (FN) is common in cancer patients particularly hematologic malignancies
due to intensive cytotoxic chemotherapy. It is an important cause of morbidity, mortality
and treatment delays. The risk is greater in patients with ANC < 500/ mm3 and increases
dramatically in those with ANC < 100/ mm3 and duration of neutropenia more than 1
week. Aims and Objectives: The purpose of this study was to evaluate the incidence, demographic characteristics,
clinical profile, mortality, outcome and factors affecting the outcome in patients
with febrile neutropenia (FN) admitted at our Center between January 2011 and November
2012. Materials and Methods: All cases of FN admitted in our Institute between January 2011 and November 2012
were analyzed. Data was analyzed using IBM statistic SPSS version 19. Results: A total of 333 episodes of FN were reviewed. Hematologic malignancies accounted for
299 (89.7%) episodes and 88% of all the episodes had grade 4 neutropenia. There was
a significant association noted between high serum bilirubin, creatinine and outcome.
Isolation of an organism from blood culture, positive findings on chest X-ray and
fungal infection was associated with higher mortality . Association between transfusion
requirements and outcome was analyzed and it was observed that patients who had multiple
component transfusions vs single component ones were at a significantly higher risk
of death. There were only 7 deaths noted among the patient population. Conclusion: Leukemias are the leading cause of FN at our Institute. Higher bilirubin, creatinine,
chest imaging favoring pneumonia, positive isolates and multiple transfusions had
significant association with mortality. Large scale prospective studies are needed
to determine the association of preemptive therapy with higher mortality. The outcome
of high risk FN in this study is favorable.
Key words
Epidemiology - febrile neutropenia - outcome
