Use of MASCC score in the inpatient management of febrile neutropenia: a single-center retrospective study

Prarthna V. Bhardwaj*, Megan Emmich, Alexander Knee, Fatima Ali, Ritika Walia, Prithwijit Roychowdhury, Jackson Clark, Arthi Sridhar, Tara Lagu, Kah Poh Loh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The Multinational Association for Supportive Care in Cancer (MASCC) score is used to risk stratify outpatients with febrile neutropenia (FN). However, it is rarely used in hospital settings. We aimed to describe management, use of MASCC score, and outcomes among hospitalized patients with FN. Methods: We conducted a retrospective cohort study of patients with cancer and FN. We collected patient demographics, cancer characteristics, microbiological profile, MASCC score, utilization of critical care therapies, documentation of goals of care (GOC), and inpatient deaths. Outcomes associated with low- (≥ 21) versus high-risk (< 21) MASCC scores are presented as absolute differences. Results: Of 193 patients, few (2%, n = 3) had MASCC scores documented, but when calculated, 52% (n = 101) had a high-risk score (< 21). GOC were discussed in 12% (n = 24) of patients. Twenty one percent (n = 40) required intermediate/ICU level of care, and 12% (n = 23) died in the hospital. Those with a low-risk score were 33% less likely to require intermediate/ICU care (95% CI 23 to 44%) and 19% less likely to die in the hospital (95% CI 10% to 27%) compared to those with high-risk score. Conclusions: MASCC score was rarely used for hospitalized patients with FN, but high-risk score was associated with worse outcomes. Education efforts to incorporate MASCC score into the workflow may help identify patients at high risk for complications and help clinicians admit these patients to a higher level of care (e.g., intermediate/ICU care) or guide them to initiate earlier GOC discussions.

Original languageEnglish (US)
Pages (from-to)5905-5914
Number of pages10
JournalSupportive Care in Cancer
Volume29
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • Cancer
  • Febrile neutropenia
  • Goals of care
  • Multinational Association for Supportive Care Score
  • Neutropenic fever

ASJC Scopus subject areas

  • Oncology

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