Real-World Data to Assess the Proportion of Patients Admitted for Febrile Neutropenia That Could Be Considered at Low Risk: The Experience of the Centre Hospitalier Universitaire de Québec

Febrile neutropenia (FN) is a serious complication of chemotherapy that often leads to hospitalization in cancer patients. It is now well-established that carefully selected patients can be safely treated on an outpatient basis. The objective of this study was to assess the number and proportion of patients hospitalized for FN in a university hospital setting who would have met the low-risk criteria for FN, and whether these patients experienced favorable outcomes during hospitalization. We conducted a retrospective study of all patients admitted for FN at three hospitals in Quebec City between 1 January 2018 and 31 December 2019. Patients with leukemia and those who had undergone stem cell transplants were excluded. A retrospective chart review was performed to establish the Multinational Association for Supportive Care in Cancer (MASCC) score for each patient. Based on predefined criteria, we also determined whether the clinical course was favorable or unfavorable. A total of 177 hospitalizations met our inclusion criteria. We found that 101/177 (57.1%) of the hospitalized patients met the low-risk FN criteria according to their MASCC score. Among these, 74/177 (41.8%) met all the criteria for outpatient treatment. The majority of these patients had a favorable outcome (70/74, 94.6%). In contrast, among patients who did not meet the eligibility criteria for outpatient treatment, 44.7% (46/103) experienced favorable outcomes during their hospitalization. These data highlight the importance of patient selection for outpatient care.