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Impact of cardiovascular comorbidities on inpatient mortality in patients hospitalized with neutropenic fever

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Abstract

Introduction

Concomitant cardiovascular comorbidities in patients with cancer are not uncommon. There is limited data on the impact of cardiovascular comorbidities on in-hospital mortality in patients admitted with neutropenic fever.

Methods

This is a retrospective cohort study using the 2016 NIS database of adults (> 18 years old) hospitalized for neutropenic fever as the primary diagnosis. The primary outcome studied is all-cause mortality in patients with neutropenic fever. ICD-10-CM codes were used to identify cardiovascular risk factors including smoking; hyperlipidemia; peripheral vascular diseases; hypertension; history of cerebrovascular disease or transient ischemic attack; and cardiovascular morbidities including atrial fibrillation, coronary artery disease, and congestive heart failure. Multivariate linear regression analysis was used to adjust for cofounders.

Results

A total of 28,060 patients were admitted with neutropenic fever in 2016. Average age was 43.9 ± 1.7 years, and 49.3% were females. Among the cases identified, 205 patients died during hospitalization with an overall in-hospital mortality of 0.7%. Atrial fibrillation was independently associated with higher in-hospital mortality (odds ratio [OR] 3.01; CI 1.38 to 6.57; p = 0.005) as was congestive heart failure (OR 3.15; CI 1.08 to 10.14; p = 0.049).

Conclusion

Atrial fibrillation and congestive heart failure were associated with higher inpatient mortality in patients with neutropenic fever. Identifying the risk factors for increased mortality in patients with neutropenic fever is important for risk stratification and guiding clinicians in taking therapeutic decisions in this set of patients.

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Authors and Affiliations

  1. Department of Medicine, University of Massachusetts Medical School, Baystate Medical Center, 759 Chestnut St., Springfield, MA, 01199, USA

    Suheil Albert Atallah-Yunes, Anis John Kadado & Khalid Sawalha

  2. Department of Medicine, Mount Sinai St Luke’s and West, New York, NY, 1090, USA

    Faris Haddadin

  3. Heart and vascular institute, Cleveland Clinic Florida, Weston, FL, 33331, USA

    Jaime Hernandez-Montfort

  4. Department of Hematology/Oncology, Saint Francis Cancer Center, Hartford, CT, 06105, USA

    Syed S. Ali

Authors
  1. Suheil Albert Atallah-Yunes
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  2. Anis John Kadado
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  3. Faris Haddadin
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  4. Khalid Sawalha
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  5. Jaime Hernandez-Montfort
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Correspondence to Khalid Sawalha.

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All authors have no conflict of interest to disclose. Authors have full control of all primary data and data can be provided if requested.

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Atallah-Yunes, S.A., Kadado, A.J., Haddadin, F. et al. Impact of cardiovascular comorbidities on inpatient mortality in patients hospitalized with neutropenic fever. Support Care Cancer 29, 509–513 (2021). https://doi.org/10.1007/s00520-020-05518-6

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  • DOI: https://doi.org/10.1007/s00520-020-05518-6

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