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Prognostic factors for risk stratification of adult cancer patients with chemotherapy-induced febrile neutropenia: A systematic review and meta-analysis

Authors

  • Yee Mei Lee BsN Adv Dip Nsg (Oncology), MNursing,

    Master of Clinical Science Candidate, Advanced Practice Nurse, Corresponding author
    1. Singapore National University Hospital Centre for Evidence Based Nursing, A Joanna Briggs Institute Collaborating Centre, Singapore
    2. The School of Translational Health Science, Faculty of Health Sciences, University of Adelaide
    3. National Cancer Institute, Singapore National University Hospital
    • Correspondence: Yee Mei, Lee School of Translational Health Science, Faculty of Health Sciences, University of Adelaide, Adelaide, North Terrace, South Australia 5005, Australia. Email: yee.lee@adelaide.edu.au

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  • Craig Lockwood RN BN GradDipClinNurs MClinSci PhD

    Program Director
    1. Translation Science, The School of Translational Health Science, Faculty of Health Sciences, University of Adelaide
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  • Conflicts of Interest
  • No known conflict of interest to report.
  • This systematic review has been submitted to the Joanna BriggsInstitute Systematic Review Library.

Abstract

Chemotherapy-induced febrile neutropenia patients are heterogeneous in their risk of adverse outcomes. Management strategies are tailored according to level of risk. Many emerging predictors for risk stratification remain controversial being based on single studies only. A systematic review was conducted to determine the strength of association of all identified predictors. Studies were obtained from electronic databases, grey literatures and reference lists.

Methodological quality of studies was assessed for internal validity and representativeness. Seven studies (four prospective and three retrospective cohorts) investigating 22 factors were reported. Fixed effects meta-analysis showed: hypotension and thrombocytopenia were significant predictors for high-risk. Additional predictors that might enhance performance of current models include: tachypnoea, presence of central venous catheter, duration and severity of neutropenia. Further research to investigate new factors/markers is needed to develop a robust prognostic model, which is the key to enhance patient safety.

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