Abstract 1828P
Background
The aim of this study was to evaluate the effect of the serum albumin/globulin (ALG) ratio on the 30-day mortality of febrile neutropenia (FEN). The second aim of the study was to evaluate the effect of combination of the ALG ratio with the MASCC and CISNE risk indexes on 30-day mortality of FEN.
Methods
Between January 2016 and May 2020, the files of patients with a diagnosis of febrile neutropenia were retrospectively evaluated, the data of MASCC and CISNE risk indexes and serum ALG ratios at the time of admission were recorded. The patients who were received at least one cycle of chemotherapy and diagnosed with FEN were screened. Patients with diseases that may affect serum albumin and globulin levels were not included in the study (e.g. chronic liver disease, multiple myeloma, nephrotic syndrome). Patients with MASCC score < 21 and CISNE score ≥ 3 were identified as a high-risk group. The median ALG ratio value was 1.13 and patients were divided into two groups according to this value. Patients with ALG ratio value ≤1.13 were identified as a high-risk group.
Results
One hundred and thirty-seven FEN episodes were included in the study. Nineteen patients (14%) had exitus within the first 30 days. The 30-day mortality rate was 96% in patients with high ALG ratios and 77% in patients with low ALG ratios (p = 0.002). According to the MASCC and CISNE risk scores, the mortality rates were 92% and 94%, respectively, in low-risk patients and 78% and 71%, respectively, in the high-risk group (p = 0.026 vs p < 0.001). A multivariate analysis with parameters that affect 30-day mortality revealed that CISNE scores ≥ 3 (OR: 4.55, CI 95% 1.61 – 12.86, p = 0.004) and ALG ratios <1.13 (OR:3.94, CI 95% 1.11 – 13.93, p = 0.033) were associated with increased 30-day mortality. In patients with MASCC<21 and CISNE >3 scores group if the ALG ratio was > 1.13, 30-day mortality rate was 93% and in those with ALG ratios ≤ 1.13 mortality rate decreased to 50% (p = 0.012).
Conclusions
A low ALG ratio in a patient with FEN associated with an increased risk of 30-day mortality. Combining the ALG ratio with MASCC and CISNE risk indexes might increase the predictive value of the scores on mortality.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Osman Sütcüoğlu.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.