The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients
The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients
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DOI：
10.1200/jco.2000.18.16.3038
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发表时间：
2000-08-01
影响因子：
45.3
通讯作者：
Talcott, J
中科院分区：
文献类型：
--
作者：
Klastersky, J;Paesmans, M;Talcott, J
目的：发热性中性粒细胞减少症仍然是抗癌化疗的潜在危及生命的并发症，但一些患者发生严重医学并发症的风险较低。本研究的目的是开发一个国际上有效的评分系统，以确定这些patients.Materials和方法：发热性前列腺癌患者进行了观察，在一项前瞻性多国研究。在随机选择的衍生集上，在发热发作时可评估的独立因素预测并发症的低风险，被分配整数权重以开发风险指数评分，随后在ct验证集上进行测试。（756例患者），预测因素是疾病负担，表明没有症状或症状轻微（体重，5;比值比[OR]，8.21;95%置信区间[CI]，4.15至16.38）或中度症状（体重，3; OR，3.70; 95% CI，2.18 - 6.29）;无低血压（体重，5; OR，7.62; 95% CI，2.91 - 19.89）;无慢性阻塞性肺疾病（体重，4; OR，5.35; 95% CI，1.86 - 15.46）;血液系统恶性肿瘤患者中存在实体瘤或既往无真菌感染（体重，4，OR，5.07; 95% CI，1.97 - 12.95）;门诊状态（重量，3; OR，3.51; 95% Cl，2.02 - 6.04）;无脱水（体重，3; OR，3.81; 95%CI，1.89至7.73）;年龄小于60岁（体重，2; OR，2.45; 95%CI，1.51至4.01）。在验证集上，多国癌症支持性护理协会风险指数评分大于或等于21名确定的法律风险患者，阳性预测值为91%，特异性为68%，灵敏度为71%。风险指数准确识别并发症风险较低的患者，并可用于选择患者来测试可能更方便的治疗策略或铸造有效，（C）2000年由美国临床肿瘤学会。
Purpose: Febrile neutropenia remains a potentially life-threatening complication of anticancer chemotherapy, but some patients are at low risk for serious medical complications. The purpose of this study was to develop an internationally validated scoring system to identify these patients.Materials and Methods: Febrile neutropenic cancer patients were observed in a prospective multinational study. Independent factors assessable at fever onset, predicting low risk of complications, on a randomly selected derivation set, were assigned integer weights to develop a risk-index score, which was subsequently tested on ct validation set.Results: On the derivation get (756 patients), predictive factors were a burden of illness indicating absence of symptoms or mild symptoms (weight, 5; odds ratio [OR], 8.21;95% confidence interval [CI], 4.15 to 16.38) or moderate symptoms (weight, 3; OR, 3.70; 95% CI, 2.18 to 6.29); absence of hypotension (weight, 5; OR, 7.62; 95% CI, 2.91 to 19.89); absence of chronic obstructive pulmonary disease (weight, 4; OR, 5.35; 95% CI, 1.86 to 15.46); presence of solid tumor or absence of previous fungal infection in patients with hematologic malignancies (weight, 4,OR, 5.07; 95% CI, 1.97 to 12.95); outpatient status (weight, 3; OR, 3.51; 95% Cl, 2.02 to 6.04); absence of dehydration (weight, 3; OR, 3.81; 95% Cl, 1.89 to 7.73); and age less than 60 years (weight, 2; OR, 2.45; 95% CI, 1.51 to 4.01). On the validation set, a Multinational Association for Supportive Care in Cancer risk-index score greater than or equal to 21 identified law-risk patients with a positive predictive value of 91%, specificity of 68%, and sensitivity of 71%.Conclusion: The risk index accurately identifies patients at low risk for complications and may be used to select patients for testing therapeutic strategies that may be more convenient or cast-effective, (C) 2000 by American Society of Clinical Oncology.