A novel approach to improving ambulatory outpatient management of low risk febrile neutropenia: an Enhanced Supportive Care (ESC) clinic
A novel approach to improving ambulatory outpatient management of low risk febrile neutropenia: an Enhanced Supportive Care (ESC) clinic
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DOI：
10.1007/s00520-018-4194-1
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发表时间：
2018-09-01
影响因子：
3.1
通讯作者：
Berman, Richard
中科院分区：
文献类型：
--
作者：
Cooksley, Tim;Campbell, Geraldine;Berman, Richard
通过MASCC评分确定的低风险发热性中性粒细胞减少患者（LRFN）的门诊管理是一种安全有效的策略。早期支持性治疗已被证明可以改善患者的治疗结果。我们开发了一个创新的门诊“增强支持性护理”（ESC）诊所，将紧急肿瘤学和支持性护理相结合，通过该诊所，我们纳入了LRFN患者的管理。ESC诊所于2017年1月在英格兰西北部的一家三级癌症医院开业。门诊的一个组成部分是为LRFN患者提供非卧床通道。MASCC评分为21分且早期预警评分为3分的患者可能符合该途径的条件。如果青霉素过敏，则对合适的患者进行口服阿莫西林/克拉维酸（500/125 mg TDS）和环丙沙星（500 mg BD）或丙沙星400 mg OD。所有患者在到达时静脉注射一剂美罗培南。在第一年，68例LRFN患者通过诊所接受治疗。表1显示了患者的人口统计学数据。6例（8.8%）患者再次入院7天。ESC门诊可能是对LRFN患者进行门诊管理的有效方法。
Outpatient management of low risk febrile neutropenia patients (LRFN) identified by the MASCC score is a safe and effective strategy. Early supportive care has been shown to improve outcomes in patients with care. We developed an innovative ambulatory outpatient "enhanced supportive care" (ESC) clinic combining emergency oncology and supportive care through which we incorporated the management of patients with LRFN.An ESC clinic was started in January 2017 at a tertiary cancer hospital in the North West of England. An integral part of the clinic was an ambulatory pathway for patients presenting with LRFN. Patients with a MASCC score a 21 and an Early Warning Score a 3 were potentially eligible for the pathway. Suitable patients were managed with oral amoxicillin/clavulanic acid (500/125 mg TDS) and ciprofloxacin (500 mg BD) or moxifloxacin 400 mg OD if penicillin allergic. All patients had one dose of intravenous meropenem on arrival.In its first year, 68 patients with LRFN were managed through the clinic. Table 1 shows the demographic data of the patients. Six (8.8%) patients had a 7-day readmission. There were no serious complications in the cohort.The ESC clinic maybe an effective method for delivering outpatient ambulatory management of patients with LRFN.