Prognosis

Although mortality from febrile neutropenia has steadily declined, the condition is still associated with considerable morbidity and mortality. Approximately 20% to 30% of patients with febrile neutropenia present with complications that require in-hospital management.[58] A retrospective study of cancer patients hospitalised with febrile neutropenia found an overall in-patient mortality of 9.5%.[12]

Length of hospital stay for high-risk patients

Approximately 80% of patients admitted with their first episode of febrile neutropenia will be hospitalised for anywhere from 1 to 10 days (40% <5 days, 42% 5 to 10 days), with a median hospital stay of 11.21 days. The length of hospital stay appears to increase with repeated episodes.[90][91]

Length of hospital stay and complications from febrile neutropenia are also associated with age >65 years, advanced stage of disease, duration and magnitude of neutropenia, pre-existing organ dysfunction and comorbid conditions, impaired performance status, and low serum albumin.[3][25]

Patients who present with hypotension, documented bloodstream infection, or pneumonia are at increased risk for complications and death.[92][93][94][95][96][97]

Risk for recurrent febrile neutropenia

Patients with a history of febrile neutropenia are at risk for subsequent episodes of febrile neutropenia.

If a patient developed febrile neutropenia during a prior cycle of chemotherapy and granulocyte colony-stimulating factor (G-CSF) prophylaxis was not used, then G-CSF prophylaxis should be considered for use with subsequent cycles of chemotherapy.[37][38][39]​​​ Risk assessment for febrile neutropenia should be carried out after each cycle of chemotherapy.

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