Universität zu Köln

Vehreschild, Maria J. G. T., Meissner, Arne M. K., Cornely, Oliver Andreas, Maschmeyer, Georg, Neumann, Silke, von Lilienfeld-Toal, Marie, Karthaus, Meinholf, Wattad, Mohammed, Staib, Peter, Hellmich, Martin ORCID: 0000-0001-5174-928X, Christ, Hildegard ORCID: 0000-0003-3235-2994 and Vehreschild, Joerg Janne (2011). Clinically defined chemotherapy-associated bowel syndrome predicts severe complications and death in cancer patients. Haematol-Hematol. J., 96 (12). S. 1855 - 1861. PAVIA: FERRATA STORTI FOUNDATION. ISSN 0390-6078

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Abstract

Background Neutropenic patients are at risk of abdominal complications and yet the incidence and impact of these complications on patients' morbidity and mortality have not been sufficiently evaluated. We aimed to assess a clinical rule for early detection of abdominal complications leading to death or transfer to intensive care in patients with chemotherapy-associated neutropenia. Design and Methods This observational multicenter study was carried out in seven German hematology-oncology departments. For inclusion, neutropenia of at least 5 consecutive days was required. Risk factors for transfer to intensive care and death were assessed by backward-stepwise binary logistic regression analyses. Chemotherapy-associated bowel syndrome was defined as a combination of fever (T >= 37.8 degrees C) and abdominal pain and/or lack of bowel movement for 72 hours or more. Five hundred and twenty-one neutropenic episodes were documented in 359 patients. Results The incidence of chemotherapy-associated bowel syndrome was 126/359 (35%) in first episodes of neutropenia. Transfer to intensive care occurred in 41/359 (11%) and death occurred in 17/359 (5%) first episodes. Chemotherapy-associated bowel syndrome and duration of neutropenia were identified as risk factors for transfer to intensive care (P<0.001; OR 4.753; 95% CI 2.297-9.833, and P=0.003; OR 1.061/d; 95% CI 1.021-1.103). Chemotherapy-associated bowel syndrome and mitoxantrone administration were identified as risk factors for death (P=0.005; OR 4.611; 95% CI 1.573-13.515 and P=0.026; OR 3.628; 95% CI 1.169-11.256). Conclusions The occurrence of chemotherapy-associated bowel syndrome has a significant impact on patients' outcome. In future interventional clinical trials, this definition might be used as a selection criterion for early treatment of patients at risk of severe complications.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, Arne M. K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Maschmeyer, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumann, Silke UNSPECIFIED UNSPECIFIED UNSPECIFIED von Lilienfeld-Toal, Marie UNSPECIFIED UNSPECIFIED UNSPECIFIED Karthaus, Meinholf UNSPECIFIED UNSPECIFIED UNSPECIFIED Wattad, Mohammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Staib, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED orcid.org/0000-0001-5174-928X UNSPECIFIED Christ, Hildegard UNSPECIFIED orcid.org/0000-0003-3235-2994 UNSPECIFIED Vehreschild, Joerg Janne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-483980
DOI:	10.3324/haematol.2011.049627
Journal or Publication Title:	Haematol-Hematol. J.
Volume:	96
Number:	12
Page Range:	S. 1855 - 1861
Date:	2011
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
ISSN:	0390-6078
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLOSTRIDIUM-DIFFICILE INFECTION; STEM-CELL TRANSPLANTATION; NEUTROPENIC ENTEROCOLITIS; ACUTE-LEUKEMIA; ABDOMINAL INFECTIONS; THERAPY; ULTRASONOGRAPHY; EPIDEMIOLOGY; OXALIPLATIN; DIARRHEA Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48398