Risk factors associated with in-hospital mortality in patients with post-chemotherapy febrile neutropenia: a cohort of patients from “Clínica Universitaria Colombia” Factores de riesgo asociados con mortalidad intrahospitalaria en pacientes con neutropenia febril posquimioterapia: una cohorte de pacientes de la Clínica Universitaria Colombia

Abstract

There is high mortality due to febrile neutropenia in patients diagnosed with cancer post-chemotherapy, with a high cost in the hospital system when not performing an early approach and management. Objective: To establish risk and protective factors associated with in-hospital mortality in patients with post-chemotherapy febrile neutropenia. Methods: A retrospective cohort study of patients diagnosed with post-chemotherapy febrile neutropenia from 2015 to 2019 and through a logistic regression analysis describe a predictive mortality model with sociodemographic, clinical, paraclinical, and microbiological factors. Results: Dehydration status (OR: 4,08 IC95% [1,16-1,34]), duration of neutropenia (OR: 1,13 IC95% [1,05-1,21]), and the time of the beginning of antibiotic after 3 hours of diagnosis (3-6 horas = OR: 3,86 IC95% [1,002-14,89], 6-9 horas = OR: 3,58 IC95% [0,38-33,82], 9-12 horas = OR: 39,35 IC95% [1,77-877,23], >12 horas = OR: 56,68 IC95% [5,24-613,50]) were directly related to mortality while weight (OR: 0,88 IC95% [0,81-0,95]) and the suitable sodium levels (OR: 0,15 IC95% [0,05-0,51]) had an inverse relation. Conclusions: Dehydration and delayed initiation of empirical antibiotics suggest that they are the main risk factors for in-hospital mortality in the study population. It is suggested to generate a multivariate model with survival analysis with a larger sample.