Evaluation of the clinical Index of Stable febrile neutropenia risk stratification system for management of febrile neutropenia in gynecologic oncology patients

• Published in: Gynecologic oncology reports 2021-08, Vol.37, p.100853-100853, Article 100853
• Main Authors: Monuszko, Karen A., Albright, Benjamin, Katherine Montes De Oca, Mary, Thao Thi Nguyen, Nguyen, Havrilesky, Laura J., Davidson, Brittany A.
• Format: Article
• Language: English
• Subjects: Research Report
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2021.100853

•The CISNE score is able to accurately identify a cohort of gynecologic oncology patients with low-risk febrile neutropenia.•The CISNE performs similarly to the MASCC score when low-risk and intermediate-risk patients are grouped together.•Lowering the CISNE threshold for low-risk febrile neutropenia may be a safer method of caring for gynecologic patients.•Using the MASCC followed by CISNE with the lower threshold yielded the most favorable performance characteristics. Scoring systems have been developed to identify low risk patients with febrile neutropenia (FN) who may be candidates for outpatient management. We sought to validate the predictive accuracy of the Clinical Index of Stable Febrile Neutropenia (CISNE) score alone and in conjunction with alternative scoring systems for risk of complications among gynecologic oncology patients. We conducted a single institution retrospective cohort study of patients admitted to an academic gynecologic oncology service for FN. We examined the performance characteristics (sensitivity, specificity, positive and negative predictive value) of three scoring systems (Multinational Association of Supportive Care in Cancer (MASCC), CISNE cut-off 1 (Low risk = 0), CISNE cut-off 2 (Low risk =