Fig 1.
Two key conditions screened 1,168 patients who visited the emergency department from January 01, 2010 to December 31, 2016: a body temperature on arrival greater than 37.5°C and an absolute neutrophil count smaller than 1000/mm3. The study finally enrolled 400 patients for analysis after excluding those who met any of exclusion criteria as illustrated. BT, body temperature; ANC, absolute neutrophil count; PTE, pulmonary thromboembolism; ASP, apparently stable patients; CUP, clinically unstable patients.
Fig 2.
A chart showing the frequencies of acute complications that destabilized febrile neutropenia patients at the emergency department.
% indicates the proportion of the entire patients (N = 400). “Decompensation” indicates decompensation of preexisting comorbidities. PTE, pulmonary thromboembolism; DIC, disseminated intravascular coagulopathy; AKI, acute kidney injury.
Table 1.
Baseline characteristics of the entire study population.
Table 2.
Clinical characteristics and outcomes of 299 apparently stable patients according to CISNE triage: CISNE I (CISNE score = 0), II (score = 1 or 2), III (score ≥3).
Statistical tests were not applied to some individual complications that occurred at very low frequency.
Fig 3.
Receiver operating characteristic (ROC) analysis with respect to the MASCC score and CISNE score.
Each variable’s AUC was 0.66 (95% CI; 0.60–0.71) and 0.64 (95% CI; 0.59–0.70), respectively. The difference between areas was 0.02 (95% CI;-0.08–0.11) and not statistically significant (P = 0.71).
Table 3.
Logistic regression analysis to predict any serious complications and composite of bacteremia or any serious complications.
Table 4.
Sensitivity and specificity of CISNE I and MASCC low risk in predicting no serious complications.
The MASCC has high sensitivity but very low specificity. By contrast, the CISNE has high specificity but very low sensitivity.