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Predictors of Outcome and Severity in Adult Filipino Patients with Febrile Neutropenia

机译:成年菲律宾中性粒细胞减少症患者的结果和严重程度的预测指标

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摘要

Aim. The study aimed to describe the profile of Filipino febrile neutropenia patients and to determine parameters associated with severe outcomes. Methods. This is a retrospective study of Filipino febrile neutropenia patients admitted to the Philippine General Hospital. Patients were described in terms of clinical presentation and stratified according to the presence or absence of severe outcomes. Prognostic factors were then identified using regression analysis. Results. 115 febrile episodes in 102 patients were identified. Regression analysis yielded prolonged fever >7 days prior to admission (OR 2.43; 95% CI, 0.77–7.74), isolation of a pathogen on cultures (OR 2.69; 95% CI, 1.04–6.98), and nadir absolute neutrophil count (ANC) < 100 during admission (OR 1.96; 95% CI, 0.75–5.12) as significant predictors of poor outcome. Factors that significantly correlated with better outcome were granulocyte colony-stimulating factor (G-CSF) use (OR 0.31; 95% CI, 0.11–0.85) and completeness of antibiotic therapy (OR 0.26; 95% CI, 0.10–0.67). Conclusion. Prolonged fever >7 days prior to admission, positive pathogen on cultures, and nadir ANC < 100 during admission predicted severe outcomes, whereas G-CSF use and complete antibiotic therapy were associated with better outcomes. These prognostic variables might be useful in identifying patients that need more intensive treatment and monitoring.
机译:目标。该研究旨在描述菲律宾发热性中性粒细胞减少症患者的概况,并确定与严重预后相关的参数。方法。这是对菲律宾总医院收治的菲律宾发热性中性粒细胞减少症患者的回顾性研究。根据临床表现对患者进行描述,并根据是否存在严重预后对患者进行分层。然后使用回归分析确定预后因素。结果。确定了102例患者中的115例高热发作。回归分析表明,入院前发烧时间> 7天(OR 2.43; 95%CI,0.77–7.74),分离出病原体(OR 2.69; 95%CI,1.04–6.98)和最低中性白细胞绝对计数(ANC) )入院时<100(OR 1.96; 95%CI,0.75–5.12)是不良结局的重要预测指标。与更好的结局显着相关的因素是粒细胞集落刺激因子(G-CSF)的使用(OR 0.31; 95%CI,0.11-0.85)和抗生素治疗的完整性(OR 0.26; 95%CI,0.10-0.67)。结论。入院前持续发烧> 7天,培养物中病原体阳性,入院时最低ANC <100,预示严重后果,而使用G-CSF和完整的抗生素治疗可改善预后。这些预后变量可能有助于识别需要更深入治疗和监测的患者。

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