Determining the Cut-Off Value of the MASCC Score to Predict Mortality in Hospitalized Febrile Neutropenic Patients: A Decade-Long Single-Center Retrospective Cohort Study.

Abstract

Introduction: Febrile neutropenia (FN) is linked to significant morbidity and mortality in cancer patients. Therefore, our study aimed to determine the cut-off value of the MASCC score to predict mortality in hospitalized FN patients.

Methods: We included 354 hospitalized cancer patients, divided into two groups: the mortality group (n = 116) and the survival group (n = 238). We defined risk factors of all-cause mortality according to a Cox regression model. The optimal cut-off value for the MASCC score was found using Youden's index.

Results: The 30-day, 60-day, and 90-day mortality rates were 25.1% (n = 89), 30.2% (n = 107), and 32.7% (n = 116), respectively. Having a hematological malignancy, advanced age, comorbidities, higher levels of C-reactive protein, and procalcitonin on admission, profound neutropenia and a lower MASCC score were statistically different in the mortality group compared to the survival group. The only independent risk factor was the MASCC score to predict all-cause mortality according to the multivariate Cox regression models. A MASCC score below 17 showed a sensitivity of 83.6% and a specificity of 94.1% for predicting all-cause mortality in hospitalized FN patients.

Conclusions: In this cohort study, we showed 30, 60 and 90-day mortality rates of hospitalized patients and determined the risk factors. We supported that the MASCC score was an independent risk factor for predicting mortality in hospitalized FN patients. We contributed to the literature by establishing a threshold value for the MASCC score, below 17, showing notably high sensitivity and specificity for predicting all-cause mortality in FN patients.