[Neutropenic Fever in Lung Cancer: Clinical Aspects Related to Mortality and Antibiotic Failure].

Abstract

BACKGROUND:

Lung cancer (LC) is the leading cause of cancer death. Patients treated with chemotherapy are at risk of developing chemotherapy-induced febrile neutropenia (FN), a potentially life-threatening complication. The aims of this study were (1) to characterize FN admissions of patients with LC in a pulmonology department, and (2) to determine associations between patient profiles, first-line antibiotic failure (FLAF) and mortality.

METHODS:

Retrospective observational case-series, based on the analysis of medical records of LC patients that required hospitalization due to chemotherapy-induced FN.

RESULTS:

A total of 42 cases of FN were revised, corresponding to 36 patients, of which 86.1% were male, with a mean age of 66.71±9.83 years. Most patients had a performance status (PS) equal or less than 1, and metastatic disease was present in 40.5% (n=17). Respiratory tract infections accounted for 42.9% (n=18) of FN cases, and multidrug-resistant Staphylococcus aureus was the most isolated agent. The mortality rate was 16.7% (n=7), and the FLAF was 26.2% (n=11). Mortality was associated with a PS≥2 (P=0.011), infection by a Gram-negative agent (P=0.001) and severe anemia (P=0.048). FLAF was associated with longer hospitalizations (P=0.020), PS≥2 (P=0.049), respiratory infections (P=0.024), and infection by a Gram-negative (P=0.003) or multidrug-resistant agent (P=0.014).

CONCLUSIONS:

Lower PS, severe anemia, and infections by Gram-negative or multi-resistant agents seem to be associated with worse outcomes in FN patients.

• Authors: Inês Rodrigues, Luísa Nascimento, Ana Cláudia Pimenta, Sara Raimundo, Bebiana Conde, Ana Fernandes
• Journal: Zhongguo fei ai za zhi = Chinese journal of lung cancer (Zhongguo Fei Ai Za Zhi) Vol. 24 Issue 11 Pg. 764-769 (Nov 20 2021) ISSN: 1999-6187 [Electronic] China
• PMID: 34802207 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Aged
• Anti-Bacterial Agents (adverse effects)
• Female
• Hospitalization
• Humans
• Lung Neoplasms (complications, drug therapy)
• Male
• Methicillin-Resistant Staphylococcus aureus
• Middle Aged
• Retrospective Studies