Marika Lappalainen1,2, Sari Hämäläinen1, Tuomo Romppanen2, Kari Pulkki3,4, Marja Pyörälä1, Irma Koivula1, Esa Jantunen1,2,5, Auni Juutilainen1,2. 1. Department of Medicine, Kuopio University Hospital, Kuopio, Finland. 2. Institute of Clinical Medicine/Internal Medicine, Faculty of Medicine, University of Eastern Finland, Kuopio, Finland. 3. Laboratory Division, Turku University Hospital, Clinical Chemistry, Faculty of Medicine, University of Turku, Turku, Finland. 4. Eastern Finland Laboratory Centre, Kuopio, Finland. 5. Department of Medicine, North Carelia Central Hospital, Joensuu, Finland.
Abstract
OBJECTIVES: To evaluate quick Sequential Organ Failure Assessment (qSOFA) score during febrile neutropenia (FN) in adult patients receiving intensive chemotherapy for acute myeloid leukemia (AML). METHODS: qSOFA score, as well as the association of qSOFA score with ICU admission, infectious mortality, blood culture findings, and C-reactive protein (CRP) measurements during FN were assessed among 125 adult AML patients with 355 FN periods receiving intensive chemotherapy in a tertiary care hospital from November 2006 to December 2018. RESULTS: The multivariate model for qSOFA score ≥ 2 included CRP ≥ 150 mg/L on d0-2 [OR 2.9 (95% CI 1.1-7.3), P = .026], Gram-negative bacteremia [OR 2.7 (95% CI 1.1-6.9), P = .034], and treatment according to AML-2003 vs more recent protocols [OR 2.7 (95% CI 1.0-7.4), P = .047]. Age or gender did not gain significance in the model. qSOFA score ≥ 2 was associated with ICU treatment and infectious mortality during FN with sensitivity and specificity of 0.700 and 0.979, and 1.000 and 0.971, respectively. CONCLUSION: qSOFA offers a useful tool to evaluate the risk of serious complications in AML patients during FN.
OBJECTIVES: To evaluate quick Sequential Organ Failure Assessment (qSOFA) score during febrile neutropenia (FN) in adult patients receiving intensive chemotherapy for acute myeloid leukemia (AML). METHODS:qSOFA score, as well as the association of qSOFA score with ICU admission, infectious mortality, blood culture findings, and C-reactive protein (CRP) measurements during FN were assessed among 125 adult AMLpatients with 355 FN periods receiving intensive chemotherapy in a tertiary care hospital from November 2006 to December 2018. RESULTS: The multivariate model for qSOFA score ≥ 2 included CRP ≥ 150 mg/L on d0-2 [OR 2.9 (95% CI 1.1-7.3), P = .026], Gram-negative bacteremia [OR 2.7 (95% CI 1.1-6.9), P = .034], and treatment according to AML-2003 vs more recent protocols [OR 2.7 (95% CI 1.0-7.4), P = .047]. Age or gender did not gain significance in the model. qSOFA score ≥ 2 was associated with ICU treatment and infectious mortality during FN with sensitivity and specificity of 0.700 and 0.979, and 1.000 and 0.971, respectively. CONCLUSION:qSOFA offers a useful tool to evaluate the risk of serious complications in AMLpatients during FN.