Evaluation of prognostic factors in febrile neutropenic patients with hematological malignancies

Abstract

Objectives: Hematological malignancies presenting with febrile neutropenia constitute an important health issue all over the globe. In this study, we aimed to elucidate the prognostic factors of febrile neutropenic patients with hematological malignancies and to investigate the causes of mortality. Method: This research had a retrospective nature. A total of 174 febrile neutropenia patients ≥ 18 years of age hospitalized have been enrolled in the study. Patients enrolled in the analysis were determined according to the American Society for Infectious Diseases 2010 Febrile Neutropenia Diagnosis and Treatment Guidelines. Accordingly, neutropenia was defined as an expected decrease in the absolute neutrophil count (ANS) to < 500 cells/mm³ or < 500 cells/mm³ over the next 48 hours and body temperature over ≥ 38°C. Results: A total of 174 patients have been included in the analysis and 32 (18.5%) died while 142 (81.5%) did not develop mortality. When the statistically significant results are evaluated according to multivariate analysis; Age, Crp, MASCC, acute renal failure, and hypotension were similar in both groups. On the other hand, when univariate statistically highly significant results are evaluated according to multivariate analysis; the Presence of urinary catheter, diagnosis of bacterial pneumonia, and ANS not increasing after 1 week were found to be statistically significant in the mortality group. Conclusion: The results of the study showed that in febrile neutropenic patients, mortality was increased by 6.7 times by a diagnosis of bacterial pneumonia, 245.6 times by the absence of ANS elevation, and 13.9 times by urinary catheterization.