title: Mortality, length of stay, and cost associated with hospitalized adult cancer patients with febrile neutropenia.
abstract: BACKGROUND
  Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand.
  
  
  METHODS
  Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia.
  
  
  RESULTS
  A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients.
  
  
  CONCLUSIONS
  FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.
authors.affiliation: Division of Oncology, Internal Medicine Department, Khon Kaen University, Khon Kaen, Thailand. jarich@kku.ac.th
authors.forename: Jarin
authors.initials: J
authors.lastname: Chindaprasirt
authors.forename: Chinadol
authors.initials: C
authors.lastname: Wanitpongpun
authors.forename: Panita
authors.initials: P
authors.lastname: Limpawattana
authors.forename: Kaewjai
authors.initials: K
authors.lastname: Thepsuthammarat
authors.forename: Warunsuda
authors.initials: W
authors.lastname: Sripakdee
authors.forename: Aumkhae
authors.initials: A
authors.lastname: Sookprasert
authors.forename: Kosin
authors.initials: K
authors.lastname: Wirasorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000191:economics; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000191:economics* / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007022:Hypotension / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000191:economics; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011014:Pneumonia / Q000191:economics; D012189:Retrospective Studies; D013785:Thailand; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents