Introduction
Febrile neutropenia is a serious complication of chemotherapy. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score can reliably identify patients with febrile neutropenia at low risk of serious complications. Outpatient management programs utilising protocol based risk stratification, daily ambulatory nursing visits, telephone follow up and early outpatient review have been successfully piloted in other Australian cancer treatment centres.
Method
We performed a retrospective review of medical records for all patients admitted at our institution with febrile neutropenia between January 1 2016 and December 31 2017. We collected information regarding patient characteristics, cancer diagnosis and treatment, determined the MASCC risk index score, and if low risk, we determined the potential eligibility for outpatient care and potential reduction in length of stay.
Results
A total of 69 hospital admissions with febrile neutropenia were analysed. Of these, 42 were determined to have a MASCC low risk index score. 33 patients met the eligibility criteria for outpatient management. The average age was 65 years. 79% were female. The median length of stay was 3.5 days. The median potential reduction in length of stay was 2 days. The total potential reduction in length of stay was 92 days. No admission resulted in serious complications.
Discussion
Febrile neutropenia is a common complication of chemotherapy and a leading cause of hospital admission. This review will lead to a prospective pilot study at our centre to institute an outpatient febrile neutropenia program for such low risk groups with potential reduction in hospital bed length of stay. This has significant implications on health resource usage and service provision planning and patient quality of life.