Clinical and Laboratory Features Predicting a Favorable Outcome and Allowing Early Discharge in Cancer Patients with Low-Risk Febrile Neutropenia: A Literature Review

2000 ◽  
Vol 9 (5) ◽  
pp. 645-649 ◽  
Author(s):  
Elio Castagnola ◽  
Dimitri Paola ◽  
Raffaella Giacchino ◽  
Claudio Viscoli
Keyword(s):  
Literature Review ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Early Discharge ◽  
Low Risk ◽  
Favorable Outcome ◽  
Laboratory Features

Assessing the impact of a targeted electronic medical record intervention on growth factor usage in cancer patients.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 262-262
Author(s):  
Jordan Bernens ◽  
Kara Hartman ◽  
Brendan F. Curley ◽  
Sijin Wen ◽  
Jame Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Low Risk ◽  
Individual Risk ◽  
Individual Risk Factors ◽  
The Impact

262 Background: Patients receiving chemotherapy are at risk for febrile neutropenia following treatment. The American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) recommend screening patients for risk of febrile neutropenia and risk stratification based on likelihood of febrile neutropenia events. Prophylactic growth factors (G-CSF) should be in patients receiving high-risk regimens or intermediate-risk regimens with individual risk factors. The impact of electronic medical record system (EMR) implementation on compliance with G-CSF support guidelines has not been studied. Methods: At West Virginia University/Mary Babb Randolph Cancer Center we conducted an IRB approved retrospective chart review of cancer patients receiving chemotherapy from January 1, 2007 to August 1, 2008 (pre-EMR) and January 1, 2011 to December 31, 2011 (post-EMR). We reviewed the chemotherapy regimens and patient risk factors for developing febrile neutropenia, and determined if the G-CSF usage was consistent with guideline recommendations. Results: Compliance with prophylactic G-CSF guidelines was 75.6% in the post-EMR arm, compared to 67.5% in the pre-EMR arm (p=0.041, ch-square). The post EMR data of 1,042 new chemotherapy initiations showed: (see Table). The appropriateness of usage in high and low risk patients were the most compliant, as G-CSF orders were built into chemotherapy plans of high risk regimens and omitted from low risk regimens. Conclusions: Appropriate prophylactic G-CSF usage can be improved when orders are integrated into standard chemotherapy order sets in an EMR. An area of further improvement would include automatic identification of individual risk factors by the EMR. [Table: see text]

A cost analysis of febrile neutropenia management in Australia: ambulatory v. in-hospital treatment

2011 ◽  
Vol 35 (4) ◽  
pp. 491 ◽  
Author(s):  
Senthil Lingaratnam ◽  
Leon J. Worth ◽  
Monica A. Slavin ◽  
Craig A. Bennett ◽  
Suzanne W. Kirsa ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Cost Analysis ◽  
Ambulatory Care ◽  
Cost Effective ◽  
Early Discharge ◽  
Cost Structure ◽  
Low Risk ◽  
Sensitivity Analyses ◽  
Medical Complications

Background. Adult febrile neutropenic oncology patients, at low risk of developing medical complications, may be effectively and safely managed in an ambulatory setting, provided they are appropriately selected and adequate supportive facilities and clinical services are available to monitor these patients and respond to any clinical deterioration. Methods. A cost analysis was modelled using decision tree analysis, published cost and effectiveness parameters for ambulatory care strategies and data from the State of Victoria’s hospital morbidity dataset. Two-way sensitivity analyses and Monte Carlo simulation were performed to evaluate the uncertainty of costs and outcomes associated with ambulatory care. Results. The modelled cost analysis showed that cost savings for two ambulatory care strategies were ~30% compared to standard hospital care. The weighted average cost saving per episode of ‘low-risk’ febrile neutropenia using Strategy 1 (outpatient follow-up only) was 35% (range: 7–55%) and that for Strategy 2 (early discharge and outpatient follow-up) was 30% (range: 7–39%). Strategy 2 was more cost-effective than Strategy 1 and was deemed the more clinically favoured approach. Conclusion. This study outlines a cost structure for a safe and comprehensive ambulatory care program comprised of an early discharge pathway with outpatient follow-up, and promotes this as a cost effective approach to managing ‘low-risk’ febrile neutropenic patients. What is known about the topic? Febrile neutropenia is a common complication of chemotherapy for patients with cancer. There is high level evidence supporting the use of ambulatory care strategies to manage patients with febrile neutropenia who are deemed to be at low risk of developing medical complications. What does this paper add? This paper highlights a cost structure for an adequately equipped and cost-effective ambulatory care strategy suitable for Australian hospitals to manage patients with low-risk febrile neutropenia. What are the implications for practitioners? The strategy advocated in this paper affords eligible patients the choice of early discharge from hospital. It advocates for improved resource utilisation and expansion of outpatient services in order to minimise opportunity costs faced by cancer treatment facilities.

scholarly journals Management of febrile neutropenia in low risk cancer patients

Thorax ◽  
2000 ◽  
Vol 55 (90001) ◽  
pp. 63S-69 ◽  
Author(s):  
H Oppenheim BA, Anderson
Keyword(s):  
Febrile Neutropenia ◽  
Cancer Patients ◽  
Low Risk

Prospective Study of Empiric Monotherapy with Ceftazidime for Low-Risk Grade IV Febrile Neutropenia after Cytotoxic Chemotherapy in Cancer Patients

Chemotherapy ◽  
2006 ◽  
Vol 52 (4) ◽  
pp. 185-189 ◽  
Author(s):  
Pnina Chernobelski ◽  
Konstantin Lavrenkov ◽  
Doron Rimar ◽  
Klaris Riesenberg ◽  
Francisc Schlaeffer ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Prospective Study ◽  
Cancer Patients ◽  
Cytotoxic Chemotherapy ◽  
Low Risk ◽  
Risk Grade
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