{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:17:35Z","timestamp":1768252655335,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["AP1104527"],"award-info":[{"award-number":["AP1104527"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1058560"],"award-info":[{"award-number":["GNT1058560"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1116876"],"award-info":[{"award-number":["GNT1116876"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Children with acquired neutropaenia due to cancer chemotherapy are at high risk of severe infection. The present study aims to describe the prevalence and predictors of poor outcomes in children with febrile neutropaenia (FN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multicentre, prospective observational study in tertiary Australian EDs. Cancer patients with FN were included. Fever was defined as a single temperature \u226538\u00b0C, and neutropaenia was defined as an absolute neutrophil count &lt;1000\/mm<jats:sup>3<\/jats:sup>. The primary outcome was the ICU admission for organ support therapy (inotropic support, mechanical ventilation, renal replacement therapy, extracorporeal life support). Secondary outcomes were: ICU admission, ICU length of stay (LOS) \u22653\u2009days, proven or probable bacterial infection, hospital LOS \u22657\u2009days and 28\u2010day mortality. Initial vital signs, biomarkers (including lactate) and clinical sepsis scores, including Systemic Inflammatory Response Syndrome, quick Sequential Organ Failure Assessment and quick Paediatric Logistic Organ Dysfunction\u20102 were evaluated as predictors of poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between December 2016 and January 2018, 2124 episodes of fever in children with cancer were screened, 547 episodes in 334 children met inclusion criteria. Four episodes resulted in ICU admission for organ support therapy, nine episodes required ICU admission, ICU LOS was \u22653\u2009days in four, hospital LOS was \u22657\u2009days in 153 and two patients died within 28\u2009days. Vital signs, blood tests and clinical sepsis scores, including Systemic Inflammatory Response Syndrome, quick Sequential Organ Failure Assessment and quick Paediatric Logistic Organ Dysfunction\u20102, performed poorly as predictors of these outcomes (area under the receiver operating characteristic curve\u2009&lt;0.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Very few patients with FN required ICU\u2010level care. Vital signs, biomarkers and clinical sepsis scores for the prediction of poor outcomes are of limited utility in children with FN.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.13978","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T02:24:18Z","timestamp":1649903058000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and predictors of poor outcome in children with febrile neutropaenia presenting to the emergency department"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0225-7953","authenticated-orcid":false,"given":"Elliot","family":"Long","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Clinical Sciences Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of 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Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Phillips","sequence":"additional","affiliation":[{"name":"Emergency Department Queensland Children's Hospital  Brisbane Queensland Australia"},{"name":"Child Health Research Centre The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Craig","sequence":"additional","affiliation":[{"name":"Clinical Sciences Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Emergency Department Monash Medical Centre  Melbourne Victoria Australia"},{"name":"Department of Paediatrics School of Clinical Sciences, Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Zhang","sequence":"additional","affiliation":[{"name":"Emergency Department John Hunter Hospital  Newcastle New South Wales 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A","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer Sir Peter MacCallum Department of Oncology, The University of Melbourne  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology The University of Melbourne  Melbourne Victoria Australia"},{"name":"Infectious Diseases Unit, Department of General Medicine The Royal Children's Hospital Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Infectious Disease Service The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Phillips","sequence":"additional","affiliation":[{"name":"Centre for Reviews and Dissemination University of York  York UK"},{"name":"Leed's Children's Hospital Leeds General Infirmary  Leeds 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