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Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure

摘要:

Background and objectives: Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of patients with LC in a pulmonology department, and (2) to determine associations between patient profiles, first-line antibiotic failure (FLAF) and mortality. Methods: Retrospective observational case-series, based on the analysis of medical records of LC patients that required hospitalization due to chemotherapy-induced FN. Results: A total of 42 cases of FN were revised, corresponding to 36 patients, of which 86.1% were male, with a mean age of 66.71±9.83 years. Most patients had a performance status (PS) equal or less than 1, and metastatic disease was present in 40.5% (n=17). Respiratory tract infections accounted for 42.9% (n=18) of FN cases, and multidrug-resistant Staphylococcus aureus was the most isolated agent. The mortality rate was 16.7% (n=7), and the FLAF was 26.2% (n=11). Mortality was associated with a PS≥2 (P=0.011), infection by a Gram-negative agent (P=0.001) and severe anemia (P=0.048). FLAF was associated with longer hospitalizations (P=0.020), PS≥2 (P=0.049), respiratory infections (P=0.024), and infection by a Gram-negative (P=0.003) or multidrug-resistant agent (P=0.014). Conclusions: Lower PS, severe anemia, and infections by Gram-negative or multi-resistant agents seem to be associated with worse outcomes in FN patients.

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作者: Inês RODRIGUES [1] Luísa NASCIMENTO [1] Ana Cláudia PIMENTA [1] Sara RAIMUNDO [1] Bebiana CONDE [1] Ana FERNANDES [1]
作者单位: Pulmonology Department,Centro Hospitalar Trás-os-Montes e Alto Douro,Vila Real,Portugal [1]
期刊: 《中国肺癌杂志》2021年24卷11期 764-769页 MEDLINEISTICPKUCSCD
栏目名称: CLINICAL RESEARCH
DOI: 10.3779/j.issn.1009-3419.2021.102.36
发布时间: 2021-11-26
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