TY - JOUR
T1 - Early discharge of low-risk febrile neutropenic children and adolescents with cancer
AU - Aquino, V. M.
AU - Tkaczewski, I.
AU - Buchanan, G. R.
N1 - Funding Information:
Received 3 September 1996; revised 7 January 1997. Financial support: This work was supported by the National Institutes of Health (T32 training grant CA09640), the Children’s Cancer Fund of Dallas, and A Weekend to Wipe Out Cancer. Reprints or correspondence: Dr George R. Buchanan, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75235-9063.
PY - 1997
Y1 - 1997
N2 - During the past decade, a relatively lower-risk patient population of febrile neutropenic children with cancer (over one-half of all these patients) has been identified. These patients can be safely discharged from the hospital before their absolute neutrophil count (ANC) exceeds 500/mm3. To evaluate the practice of early discharge of these patients, 580 consecutive episodes of chemotherapy-induced febrile neutropenia in 253 children and adolescents with cancer between June 1992 and May 1995 were reviewed. Three hundred thirty episodes ended in discharge before the patient's ANC was > 500/mm3. Patients were characterized as being at relatively lower risk if they had sterile blood cultures, were afebrile for >24 hours, appeared well, and were thought to have evidence of marrow recovery. Of the 330 episodes, only 21 (6%) were associated with admission for recurrent fever during the subsequent 7 days. In retrospect, in only six of these 21 cases of readmission (or 2% of 330 episodes) was there evidence of bone marrow recovery, and none of the blood cultures were positive during the subsequent hospitalization. All patients who met low-risk criteria fared well during their second hospitalization. This early discharge strategy was safe and resulted in substantial cost savings.
AB - During the past decade, a relatively lower-risk patient population of febrile neutropenic children with cancer (over one-half of all these patients) has been identified. These patients can be safely discharged from the hospital before their absolute neutrophil count (ANC) exceeds 500/mm3. To evaluate the practice of early discharge of these patients, 580 consecutive episodes of chemotherapy-induced febrile neutropenia in 253 children and adolescents with cancer between June 1992 and May 1995 were reviewed. Three hundred thirty episodes ended in discharge before the patient's ANC was > 500/mm3. Patients were characterized as being at relatively lower risk if they had sterile blood cultures, were afebrile for >24 hours, appeared well, and were thought to have evidence of marrow recovery. Of the 330 episodes, only 21 (6%) were associated with admission for recurrent fever during the subsequent 7 days. In retrospect, in only six of these 21 cases of readmission (or 2% of 330 episodes) was there evidence of bone marrow recovery, and none of the blood cultures were positive during the subsequent hospitalization. All patients who met low-risk criteria fared well during their second hospitalization. This early discharge strategy was safe and resulted in substantial cost savings.
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U2 - 10.1086/514512
DO - 10.1086/514512
M3 - Article
C2 - 9243037
AN - SCOPUS:0030806231
SN - 1058-4838
VL - 25
SP - 74
EP - 78
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 1
ER -