Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Mortality, Length of Stay, and Cost Associated with Hospitalized Adult Cancer Patients with Febrile Neutropenia

  • Chindaprasirt, Jarin (Division of Oncology, Faculty of Medicine, Khon Kaen University) ;
  • Wanitpongpun, Chinadol (Division of Hematology, Faculty of Medicine, Khon Kaen University) ;
  • Limpawattana, Panita (Division of Geriatric Medicine, Internal Medicine Department, Faculty of Medicine, Khon Kaen University) ;
  • Thepsuthammarat, Kaewjai (Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University) ;
  • Sripakdee, Warunsuda (Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University) ;
  • Wirasorn, Kosin (Division of Oncology, Faculty of Medicine, Khon Kaen University) ;
  • Sookprasert, Aumkhae (Division of Oncology, Faculty of Medicine, Khon Kaen University)
  • Published : 2013.02.28
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Abstract

Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

Keywords

References

  1. Bodey GP, Buckley M, Sathe YS, et al (1966). Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med, 64, 328-40. https://doi.org/10.7326/0003-4819-64-2-328
  2. Chindaprasirt J, Sookprasert A, Wirasorn K, et al (2012). Cost of colorectal cancer care in hospitalized patients of Thailand. J Med Assoc Thai, 95, 196-200.
  3. Courtney DM, Aldeen AZ, Gorman SM, et al (2007). Cancer-associated neutropenic fever: clinical outcome and economic costs of emergency department care. The Oncologist, 12,19-26.
  4. Ellis M (2008). Febrile neutropenia evolving strategies. Ann N Y Acad Sci, 1138, 329-50. https://doi.org/10.1196/annals.1414.035
  5. Elting LS, Lu C, Escalante CP, et al (2008). Outcomes and cost of outpatient or inpatient management of 712 patients with febrile neutropenia. J Clin Oncol, 26, 606-11. https://doi.org/10.1200/JCO.2007.13.8222
  6. Hollenberg CH (1996). The effect of health care reform on academic medicine in Canada. Editorial committee of the Canadian institute for academic medicine. CMAJ, 154, 1483-9.
  7. Innes H, Lim SL, Hall A, et al (2008). Management of febrile neutropenia in solid tumours and lymphomas using the Multinational Association for Supportive Care in Cancer (MASCC) risk index: feasibility and safety in routine clinical practice. Support Care Cancer, 16, 485-91 . https://doi.org/10.1007/s00520-007-0334-8
  8. Jin J, Lee YM, Ding Y, et al (2010). Prospective audit of febrile neutropenia management at a tertiary university hospital in Singapore. Ann Acad Med Singapore, 39, 453-9.
  9. Kuderer NM, Dale DC, Crawford J, et al (2006). Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer, 106, 2258-66. https://doi.org/10.1002/cncr.21847
  10. Lal A, Bhurgri Y, Rizvi N, et al (2008). Factors influencing in-hospital length of stay and mortality in cancer patients suffering from febrile neutropenia. Asian Pac J Cancer Prev, 9, 303-8.
  11. Liou SY, Stephens JM, Carpiuc KT, et al (2007). Economic burden of haematological adverse effects in cancer patients: a systematic review. Clin Drug Investig, 27, 381-96. https://doi.org/10.2165/00044011-200727060-00002
  12. Schelenz S, Giles D, Abdallah S (2012). Epidemiology, management and economic impact of febrile neutropenia in oncology patients receiving routine care at a regional UK cancer centre. Ann Oncol, 23, 1889-93. https://doi.org/10.1093/annonc/mdr520
  13. Schilling MB, Parks C, Deeter RG (2011). Costs and outcomes associated with hospitalized cancer patients with neutropenic complications: a retrospective study. Exp Ther Med, 2, 859-66.
  14. Stokes ME, Muehlenbein CE, Marciniak MD, et al (2009). Neutropenia-related costs in patients treated with first-line chemotherapy for advanced non-small cell lung cancer. J Manag Care Pharm, 15, 669-82.
  15. Teuffel O, Amir E, Alibhai S, et al (2011). Cost effectiveness of outpatient treatment for febrile neutropaenia in adult cancer patients. Br J Cancer, 26, 1377-83.

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