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Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings.

Publication ,  Journal Article
Weycker, D; Barron, R; Kartashov, A; Legg, J; Lyman, GH
Published in: J Oncol Pharm Pract
June 2014

OBJECTIVE: To examine the incidence, treatment, and consequences of febrile neutropenia across inpatient and outpatient care settings. METHODS: Data were obtained from Humedica's National Electronic Health Record-Derived Longitudinal Patient-Level Database (2007-2010). The study population included adult patients who received myelosuppressive chemotherapy for a solid tumor or non-Hodgkin's lymphoma. For each patient, each chemotherapy regimen course and each cycle within each regimen course was characterized. Febrile neutropenia episodes were identified on a cycle-specific basis based on any of the following: (1) absolute neutrophil count <1.0 × 10(9)/L and evidence of infection or fever; (2) inpatient diagnosis of neutropenia, fever, or infection; (3) outpatient diagnosis of neutropenia and non-prophylactic antimicrobial use; or (4) mention of febrile neutropenia in physician notes. Febrile neutropenia episodes were categorized as inpatient or outpatient based on the initial setting of care (i.e. acute-care inpatient facility vs. ambulatory care facility). Febrile neutropenia consequences included hospital length of stay and mortality (inpatient cases only), as well as number of febrile neutropenia-related outpatient encounters. RESULTS: Among the 2131 patients in this study, 401 experienced a total of 458 febrile neutropenia episodes. Risk of febrile neutropenia during the chemotherapy regimen course was 16.8% (95% CI: 15.3, 18.4). In cycle 1 alone, risk of febrile neutropenia was 8.1% (7.1, 9.3). Most febrile neutropenia episodes (83.2%) were initially treated in the inpatient setting; the hospital mortality rate was 8.1% (5.8, 11.1), and mean hospital length of stay was 8.4 days (7.7, 9.1). Among febrile neutropenia episodes initially treated in the outpatient setting (16.8%), the mean number of outpatient management encounters was 2.6 (2.1, 3.1), most of which were in the physician's office (69.2%) or emergency department (26.9%). CONCLUSIONS: Febrile neutropenia remains a common occurrence among patients receiving myelosuppressive chemotherapy and typically results in extended hospitalization and, for many patients, death. A minority of patients are, however, treated exclusively on an outpatient basis.

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Published In

J Oncol Pharm Pract

DOI

EISSN

1477-092X

Publication Date

June 2014

Volume

20

Issue

3

Start / End Page

190 / 198

Location

England

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Outpatients
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Inpatients
  • Incidence
  • Humans
  • Female
 

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MLA
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Weycker, D., Barron, R., Kartashov, A., Legg, J., & Lyman, G. H. (2014). Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings. J Oncol Pharm Pract, 20(3), 190–198. https://doi.org/10.1177/1078155213492450
Weycker, Derek, Richard Barron, Alex Kartashov, Jason Legg, and Gary H. Lyman. “Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings.J Oncol Pharm Pract 20, no. 3 (June 2014): 190–98. https://doi.org/10.1177/1078155213492450.
Weycker D, Barron R, Kartashov A, Legg J, Lyman GH. Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings. J Oncol Pharm Pract. 2014 Jun;20(3):190–8.
Weycker, Derek, et al. “Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings.J Oncol Pharm Pract, vol. 20, no. 3, June 2014, pp. 190–98. Pubmed, doi:10.1177/1078155213492450.
Weycker D, Barron R, Kartashov A, Legg J, Lyman GH. Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings. J Oncol Pharm Pract. 2014 Jun;20(3):190–198.
Journal cover image

Published In

J Oncol Pharm Pract

DOI

EISSN

1477-092X

Publication Date

June 2014

Volume

20

Issue

3

Start / End Page

190 / 198

Location

England

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Outpatients
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Inpatients
  • Incidence
  • Humans
  • Female