A157: Role of MASCC score in the Management of Neutropenic Sepsis at Ysbyty Glan Clwyd
1North Wales Cancer Treatment Centre, Rhyl, UK
Neutropenic Sepsis (NS) is a medical emergency and patients (pts) with NS can be stratified in to low or high risk groups by using Multinational association for supportive care in cancer (MASCC) score, as recommended by NICE. Low risk pts can be treated with oral antibiotics and discharged early.
Aim of this study is to evaluate the role of MASCC score in the management of pts with NS at Ysbyty Glan Clwyd (YGC).
We retrospectively reviewed clinical case notes, discharge letters and electronic pathology records of patients treated for NS at YGC between August 2013 and August 2014. MASCC score was used retrospectively to stratify pts as low or high risk.
A total of 40 pts were admitted with the diagnosis of NS between August 2013 and August 2014. Twenty (50%) pts were identified as low risk and 20(50%) pts as high risk.
Among the low risk pts, mean neutrophil count was 0.36 (0.02-1.05) on admission and 3.509 (0.4-12.05) at the time of discharge. Median length of stay was 3.5 (1-12) days. Median duration of treatment with IV antibiotics was 2.5 (1-7) days. Inpatient hospital stay was ? 5 days in 5 (25%) pts due to social reasons (n=1) and minor symptom control (n=4).
Among the High risk pts, mean neutrophil count was 0.39 (0.01-0.9) on admission and 4.387 (0.3-10.3) at the time of discharge. Median length of stay was 5 (1-14) days. Median duration of treatment with IV antibiotics was 4 (1-7) days with 7 (35%) pts receiving IV antibiotics for > 6 days.
Lack of use of MASCC scoring system has led to indiscriminate use of IV antibiotics and prolonged hospital stay. Appropriate use of MASCC score at the time of hospital admission in pts with NS would have helped to reduce length of stay and unnecessary administration of IV antibiotics.