METHODS: Prospective, multicentre study, carried out between 2016 and 2020 in six hospitals in Chile. The defined cohort corresponds to a dynamic group of HRFN episodes in patients <18 years old with cancer, who at the fourth day of evolution still presented fever and neutropenia (persistent HRFN). Each episode was followed until resolution of FN. The incidence of IFD was calculated between 2016 and 2020 and compared with data obtained in the period 2004-2006. The incidence rate was estimated.
RESULTS: A total of 777 episodes of HRFN were analysed; 257 (33.1%) were considered as persistent-HRFN occurring in 174 patients. The median age was 7 years (IQR: 3-12 years) and 52.3% (N = 91) were male. Fifty-three episodes of IFD were detected: 21 proven, 14 probable and 18 possible. Possible IFD were excluded, leaving 239 episodes of persistent-HRFN with an IFD incidence of 14.6% (95% CI 10.5-19.9) and an incidence rate of 13.6 IFD cases per 1000 days of neutropenia (95% CI 9.5-20.0). Compared to 2004-2006 cohort (incidence: 8.5% (95% CI 5.2-13.5)), a significant increase in incidence of 6.1% (95% CI 0.2-12.1, p = .047) was detected in cohorts between 2016 and 2020.
CONCLUSIONS: We observed a significant increase in IFD in 2016-2020, compared to 2004-2006 period.
方法:前瞻性,多中心研究,2016年至2020年在智利的六家医院进行。定义的队列对应于<18岁的癌症患者的HRFN发作的动态组,在进化的第四天仍然出现发烧和中性粒细胞减少症(持续性HRFN)。每集都在FN解决之前。IFD的发病率是在2016年至2020年之间计算的,并与2004年至2006年期间获得的数据进行比较。估计发病率。
结果:共分析了777例HRFN;174例患者中257例(33.1%)被认为是持续性HRFN。中位年龄为7岁(IQR:3-12岁),男性占52.3%(N=91)。检测到53例IFD:21例证实,14个可能,18个可能。可能的IFD被排除,留下239次持续性HRFN发作,IFD发生率为14.6%(95%CI10.5-19.9),每1000天中性粒细胞减少症发生率为13.6例IFD(95%CI9.5-20.0)。与2004-2006年队列相比(发病率:8.5%(95%CI5.2-13.5)),2016~2020年,队列中的发病率显著增加6.1%(95%CI0.2~12.1,p=.047).
结论:我们观察到,与2004-2006年相比,2016-2020年的IFD显着增加。