Dataset Information

Temperatures, diagnostics and treatment in pediatric cancer patients with fever in neutropenia, NCT01683370.

ABSTRACT: In pediatric oncology, there is no evidence-based definition of the temperature limit defining fever (TLDF), which itself is essential for the definition of fever in chemotherapy-induced severe neutropenia (FN). Lowering the TLDF can increase the number of FN episodes diagnosed. This prospective, single center observational study collected data on all temperature measurements, complete blood counts (CBCs), and measures of diagnostics and therapy performed at and after FN diagnosis in pediatric oncology patients using a high standard TLDF (39?°C ear temperature). In 45 FN episodes in 20 patients, 3391 temperature measurements and 318 CBCs, plus information on antibiotics, anti-fungal therapy, antipyretics, blood cultures taken and on discharge were collected. These data can mainly be used to study the influence of virtually lowering the TLDF on diagnostic measures, treatment and length of hospitalization in pediatric FN, which in turn are directly related to costs of FN therapy, and quality of life. This approach can be expanded to include as well different definitions of neutropenia.

SUBMITTER: Brack E

PROVIDER: S-EPMC7250883 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Temperatures, diagnostics and treatment in pediatric cancer patients with fever in neutropenia, NCT01683370.

Brack Eva E Wagner Stéphanie S Stutz-Grunder Eveline E Agyeman Philipp K A PKA Ammann Roland A RA

Scientific data 20200526 1

In pediatric oncology, there is no evidence-based definition of the temperature limit defining fever (TLDF), which itself is essential for the definition of fever in chemotherapy-induced severe neutropenia (FN). Lowering the TLDF can increase the number of FN episodes diagnosed. This prospective, single center observational study collected data on all temperature measurements, complete blood counts (CBCs), and measures of diagnostics and therapy performed at and after FN diagnosis in pediatric o ...[more]

PMID: 32457478

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Project description:Neutropenia is a common side effect of myelosuppressive chemotherapy and is associated with adverse outcomes. Early Warning Scores are used to identify at-risk patients and facilitate rapid clinical interventions. Since few Early Warning Scores have been validated in patients with neutropenia, we aimed to create predictive models and nomograms of fever, ICU transfer, and mortality in hospitalized neutropenic patients.DesignDevelopment of statistical prediction models and nomograms using data from a retrospective cohort study of hospitalized patients with neutropenia.SettingUniversity of Virginia Medical Center, a tertiary-care academic medical center in Charlottesville, VA.PatientsThe derivation and validation cohorts included hospitalized adult patients with neutropenia who were admitted to the inpatient wards between October 2010 and January 2015, and April 2017 and April 2020, respectively. We defined neutropenia as an absolute neutrophil count of less than 500 cells/mm3.InterventionsNone.Measurements and main resultsThe derivation cohort included 1,531 hospital admissions in patients with neutropenia. Fever, ICU transfer, and in-hospital mortality occurred in 955 admissions (62%), 297 admissions (19%), and 147 admissions (10%), respectively. In the derivation cohort, the internally validated area under the curves with 95% CI for the fever, ICU transfer, and mortality models were HYPERLINK "callto:0.74%20(0.67-0.84),%200.77"0.74 (0.67-0.84), 0.77 (0.67-0.86), and HYPERLINK "callto:0.95%20(0.0.87-1.0"0.95 (0.0.87-1.0), respectively. The validation cohort included 1,250 admissions in patients with neutropenia. In the validation cohort, the area under the curve (95% CI) for the fever, ICU transfer, and mortality models were HYPERLINK "callto:0.70%20(0.67-0.73),%200.78"0.70 (0.67-0.73), 0.78 (0.72-0.84), and HYPERLINK "callto:0.91%20(0.88-0.94"0.91 (0.88-0.94), respectively. Using these models, we developed clinically applicable nomograms which detected adverse events a median of 4.0-11.4 hours prior to onset.ConclusionsWe created predictive models and nomograms for fever, ICU transfer, and mortality in patients with neutropenia. These models could be prospectively validated to detect high-risk patients and facilitate early clinical intervention to improve patient outcomes.

Dataset Information

Temperatures, diagnostics and treatment in pediatric cancer patients with fever in neutropenia, NCT01683370.

Publications

Temperatures, diagnostics and treatment in pediatric cancer patients with fever in neutropenia, NCT01683370.

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