The Multinational Association for Supportive Care in cancer criteria. An Evaluation and recommendations for the management of neutropenia in the emergency department

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2024-11-19 DOI:10.1016/j.ienj.2024.101542

Anas Alsharawneh

{"title":"The Multinational Association for Supportive Care in cancer criteria. An Evaluation and recommendations for the management of neutropenia in the emergency department","authors":"Anas Alsharawneh","doi":"10.1016/j.ienj.2024.101542","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to evaluate the reproducibility, accuracy, feasibility, and effect of the Multinational Association for Supportive Care in Cancer (MASCC) criteria on emergency clinical decisions, treatment, and health outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort design was used.</div></div><div><h3>Results</h3><div>The MASCC score was better at correctly detecting the high urgency (70 % of patients with a high urgency were identified as high risk) than the low urgency (only 30 % of patients with a low urgency were identified as low risk). The examination of the MASCC score as a continuous variable could have been more valuable and indicated inferior validity. The likelihood ratios were far from good, which is better for ruling out the high urgency. The observed likelihood ratio of the MASCC range 17 to 20 provided no information for the goodness of the scale (equal to one). The results from multiple linear regression analyses identified that the MASCC original categorization (high vs. low risk) and the investigated new one (multiple ranges of MASCC score) were significantly associated with time to reassessment, time to be seen, time to decide on admission, boarding time until disposition, and length of stay. However, the original categorization nor the new one was predictive of the admission site. Still, both were significantly associated with hospital disposition (mortality) (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>Even though the MASCC score determines the neutropenia treatment pathway, the sensitivity and specificity analysis identified that the scale did not perform well in detecting real clinical urgency.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"78 ","pages":"Article 101542"},"PeriodicalIF":1.8000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Emergency Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1755599X2400137X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

We aimed to evaluate the reproducibility, accuracy, feasibility, and effect of the Multinational Association for Supportive Care in Cancer (MASCC) criteria on emergency clinical decisions, treatment, and health outcomes.

Methods

A retrospective cohort design was used.

Results

The MASCC score was better at correctly detecting the high urgency (70 % of patients with a high urgency were identified as high risk) than the low urgency (only 30 % of patients with a low urgency were identified as low risk). The examination of the MASCC score as a continuous variable could have been more valuable and indicated inferior validity. The likelihood ratios were far from good, which is better for ruling out the high urgency. The observed likelihood ratio of the MASCC range 17 to 20 provided no information for the goodness of the scale (equal to one). The results from multiple linear regression analyses identified that the MASCC original categorization (high vs. low risk) and the investigated new one (multiple ranges of MASCC score) were significantly associated with time to reassessment, time to be seen, time to decide on admission, boarding time until disposition, and length of stay. However, the original categorization nor the new one was predictive of the admission site. Still, both were significantly associated with hospital disposition (mortality) (p < 0.05).

Conclusion

Even though the MASCC score determines the neutropenia treatment pathway, the sensitivity and specificity analysis identified that the scale did not perform well in detecting real clinical urgency.

查看原文本刊更多论文

多国癌症支持性治疗协会标准。对急诊科中性粒细胞减少症处理的评估和建议。

目的我们旨在评估多国癌症支持性治疗协会（MASCC）标准的可重复性、准确性、可行性以及对急诊临床决策、治疗和健康结果的影响：方法：采用回顾性队列设计：结果：MASCC评分在正确检测高危急症方面（70%的高危急症患者被认定为高危）优于低危急症（仅30%的低危急症患者被认定为低危）。将 MASCC 评分作为一个连续变量进行研究可能更有价值，但其有效性较差。似然比远远不够，这更有利于排除高危急症。观察到的 MASCC 17 至 20 分的似然比没有提供量表好坏的信息（等于 1）。多元线性回归分析结果表明，MASCC 原始分类（高危与低危）和新调查分类（MASCC 评分的多个范围）与重新评估时间、就诊时间、决定入院时间、处置前的住院时间和住院时间有显著相关性。但是，原始分类和新分类都不能预测入院地点。尽管如此，两者都与入院处置（死亡率）有明显相关性（P 结论）：尽管 MASCC 评分决定了中性粒细胞减少症的治疗路径，但敏感性和特异性分析表明，该量表在检测真正的临床紧迫性方面表现不佳。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.