Prospective Evaluation of a Model of Prediction of Invasive Bacterial Infection Risk among Children with Cancer, Fever, and Neutropenia

• Published in: Clinical infectious diseases Vol. 35; no. 6; pp. 678 - 683
• Main Authors: Santolaya, M. E., Alvarez, A. M., Avilés, C. L., Becker, A., Cofré, J., Enríquez, N., O'Ryan, M., Payá, E., Salgado, C., Silva, P., Tordecilla, J., Varas, M., Villarroel, M., Viviani, T., Zubieta, M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-09-2002; University of Chicago Press
• Subjects: Adolescent; Bacteremia; Bacterial infections; Bacterial Infections - epidemiology; Bacterial Infections - etiology; Biological and medical sciences; Child; Child health services; Child, Preschool; Children; Fever; Fever - etiology; Hematologic and hematopoietic diseases; Humans; Hypotension; Infections; Major Articles; Medical sciences; Modeling; Models, Statistical; Neoplasms - complications; Neutropenia; Neutropenia - etiology; Other diseases. Hematologic involvement in other diseases; Predisposing factors; Prospective Studies; Reproducibility of Results; Risk Factors; Human; Leukopenia; Hemopathy; Malignant tumor; Modeling; Fever; Infection; Sepsis syndrome; Sensitivity; Specificity; Risk factor; Bacteriosis; Predictive value; Complication; Models; Predictive factor; Child; Neutropenia
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/342064

A risk prediction model for invasive bacterial infection (IBI) was prospectively evaluated among children presenting with cancer, fever, and neutropenia. The model incorporated assessment of 5 previously identified risk factors: serum level of C-reactive protein (CRP) ⩾90 mg/L, hypotension, identification of relapse of leukemia as the cancer type, platelet count of ⩽50,000 platelets/mm3, and recent receipt of chemotherapy [16]. Children were uniformly evaluated at enrollment and were classified as having high or low risk for IBI according to a model that considers the number and type of variables present. Of the 263 febrile episodes evaluated during a 17-month period, 140 (53%) were in IBI-positive children. The sensitivity, specificity, and positive and negative predictive values of the model were 92%, 76%, 82%, and 90%, respectively. Identification of these 5 risk factors during the first 24 h of hospitalization was helpful in discriminating between children with a high or low risk for IBI.