Critically ill patients with cancer: A clinical perspective

Table 6 Risk-stratification tools for patients with febrile neutropenia[54,60-62]

Description/Criteria	Group/ Points
Talcott classification system
Patients hospitalized at onset of fever and neutropenia (inpatient at presentation)	1
Outpatients at presentation but with comorbidities which require hospitalization	2
Outpatients at presentation with uncontrolled cancer but without comorbidities	3
Outpatients at presentation without comorbidities and controlled cancer	4
Multinational association of supportive care of cancer (MASCC) risk-index
Burden of febrile neutropenia
No or mild symptoms: No fever, hemodynamic compromise or clinically significant signs and symptoms of particular site of infection	5
Moderate symptoms: Any others not included in mild or severe symptoms	3
Severe symptoms: High grade fever, any hemodynamic compromise or any of the serious complications requiring high dependency unit support	0
No hypotension (systolic blood pressure > 90 mmHg)	5
Solid tumor or hematological malignancy with no previous fungal infection	4
No chronic obstructive pulmonary disease	4
No dehydration requiring parenteral fluids	3
Outpatient status	3
Age < 60 yr	2
Clinical Index of Stable Febrile Neutropenia (CISNE) score
Eastern Cooperative Oncology Group performance status ≥ 2	2
Stress-induced hyperglycemia	2
Chronic obstructive pulmonary disease (on steroids, supplemental oxygen, or bronchodilators)	1
Chronic cardiovascular disease (excluding single uncomplicated episode of atrial fibrillation)	1
Mucositis (at least the presence of patchy ulcerations or pseudomembranes, or moderate pain with modified diet)	1
Monocytes < 200 cells/mm3	1