The following is a summary of “Predicting ER Visits in Chemo-Induced Febrile Neutropenia Patients,” published in the May 2023 issue of Emergency Medicine by Sejin et al.

Although chemotherapy-induced febrile neutropenia (FN) is the most common and life-threatening oncologic emergency, the characteristics and outcomes of these patients return visits to the emergency department (ED) are unknown. Therefore, researchers sought to investigate the predictive factors and clinical outcomes of chemotherapy-induced FN patients who returned to the emergency department. This 14-year, retrospective, single-center observational study included chemotherapy-induced FN patients who visited the emergency department and were discharged.

 The primary outcome was a repeat visit within five days to the ED. They conducted logistic regression analyses to evaluate the factors influencing a patient’s return to the emergency department. This study included 1,318 FN patients; 154 (12.1%) returned to the ED within five days. Patients returned to the ED at a rate of 53.3% due to persistent fever at 56.5%, with no admissions to the intensive care unit and only one hopelessly discharged fatality.

Multivariable analysis revealed that shock index >0.9 (odds ratio [OR]: 1.45, 95% CI, 1.01–2.10), thrombocytopenia (<100 × 103/uL) (OR: 1.64, 95% CI, 1.11–2.42), and lactic acid level > 2 mmol/L (OR: 1.51, 95% CI, 0.99–2.25) were associated with an increased risk of a return visit to the ED, whereas being transferred into the ED from other hospitals (OR: 0.08; 95% CI, 0.005–0.38) was associated with a decreased risk of a return visit to the ED. In chemotherapy-induced FN patients, a big shock index, lactic acid, thrombocytopenia, and ED arrival type can predict return visits to the ED.

Source: sciencedirect.com/science/article/abs/pii/S0735675723000815