Clinical, laboratory, treatment profiles and outcome of neutropenic fever among high-risk hematologic patients in Tikur Anbessa Specialized Hospital 2019, Ethiopia.

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Addis Abeba University


Background Patients with hematologic malignancy are at a higher risk to develop neutropenic fever. The febrile neutropenia episodes are associated with increase in morbidity and mortality of these patients. Outcome of each of the episodes of febrile neutropenia is associated with the clinical, laboratory, microbiological, imaging for source of infection and antimicrobial and chemotherapy regimen the patients is taking. Objectives The purpose of this study was to assess the correlation of the clinical, laboratory and treatment profiles of the patients with neutropenic fever and hematologic malignancy with all-cause mortality in 30 days of diagnosis of the neutropenic fever episode at Tikur Anbessa Specialized Hospital. Methods A single center, cross sectional retrospective study was conducted in hematology and medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia for the year 2019. The clinical profiles with history and presumed site of infection, treatment plans and outcome in 30 days of diagnosis of the NF episode were retrieved from medical charts. Chest imaging results during the diagnosis of the febrile neutropenia episode were taken from the Med Web intranet database of the institution. The microbiology data for the specimens collected for culture was retrieved form the log book at the microbiology department of the Hospital. The data was subjected to bivariate and multivariate analysis using SPSS Ver 26. Results A sample of 132 patients with hematologic malignancy and neutropenic fever episode in the year 2019 were assessed. The study revealed that among patients with febrile neutropenia male to female ratio was 13:10. The patients had ALL (43.2%) and AML (40.9%) as the common underlying diseases. Frequent site of primary infection was chest focus (33%). More than half of the patients were on combination therapy with Cefepime and Vancomycin (40.9%). The odds of dying in 30 days of diagnosis was 5.4 times higher in patients with Medical ICU admission [AOR= 5.4; 95% CI: 1.22 - 23.92] and 3.8 higher in those with past history of febrile neutropenia [AOR= 3.8; 1.44 - 10.16]. Conclusion The history of prior treatment for febrile neutropenia and medical ICU admission during the course of treatment of febrile neutropenia of patients with hematologic malignancy predicted all-cause in hospital mortality in 30 days.



Febrile neutropenia, hematology malignancy, all-cause mortality