Clinical Consequences and Economic Burden Associated with Febrile Neutropenia in Hospitalized Cancer Patients: A Prospective Study

Tamanna Bahar, Shaila Rahman, Zulfia Zinat Chowdhury, T. Kabir, Fahmida Akther, Salina Haque, A. Islam, M. Ali, Md. Mahbubur Rahman
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Abstract

Objective: Febrile neutropenia (FN) is viewed as the most decimating oncological crisis particularly inchemotherapy-incited patients. The primary objective of the study was to identify the total directexpenditure of patients during febrile neutropenia with clinical consequences and the secondary aim wasto find out the factors associated with higher cost. Materials and Method: This was a single-centered hospital-based study in the largest and only specializedcancer care centre in Bangladesh in the government sector. This prospective study was done in theinpatients’ department of the National Institute of Cancer Research and Hospital from April 2020 toJanuary 2021. The primary outcome was the out-of-pocket patient payments (adjusted by governmentsubsidy) per FN episode. Univariate analysis and multiple linear regression were conducted to identifythe factors associated with higher costs. Results and Discussions: A total of 101 patients were enrolled in the study. The mean (SD) age was33.49 (±15.79) years. Of the 101 participants, 63.4% were male. Among the patients, 13.9% died during theepisode and 86.1% recovered. Having co-morbidities and COVID-19 were associated with an increasedrisk of death. The mean cost was US$ 999.44 (±499.05) and the mean length of hospital stay was 21.98(±9.3) days. The longer hospital stay was significantly associated with higher costs. Conclusion: This study will help to ascertain the hospital cost and clinical outcome of FN whichultimately can help in policymaking strategy. J MEDICINE 2022; 23: 48-53
住院癌症患者发热性中性粒细胞减少症的临床后果和经济负担:一项前瞻性研究
目的:发热性中性粒细胞减少症(FN)被认为是最致命的肿瘤危机,特别是在化疗患者中。本研究的主要目的是确定发热性中性粒细胞减少症患者的总直接支出与临床后果,次要目的是找出与高成本相关的因素。材料和方法:这是一项单中心医院研究,在孟加拉国政府部门最大也是唯一的专业癌症护理中心进行。这项前瞻性研究于2020年4月至2021年1月在国家癌症研究所和医院的住院病人部进行。主要结果是每次FN发作的患者自付费用(经政府补贴调整)。通过单因素分析和多元线性回归分析,确定了与高成本相关的因素。结果和讨论:共有101例患者入组研究。平均(SD)年龄为33.49(±15.79)岁。在101名参与者中,63.4%是男性。13.9%的患者在发作期间死亡,86.1%的患者康复。合并疾病和COVID-19与死亡风险增加有关。平均费用为999.44美元(±499.05),平均住院时间为21.98(±9.3)天。住院时间越长,费用越高。结论:本研究有助于确定FN的医院成本和临床效果,最终为政策制定提供依据。[J]中华医学杂志2022;23: 48-53
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