| A clinical definition for chemotherapy-associated bowel syndrome predicts severe complications and death in cancer patients. | |
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MedLine Citation:
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PMID: 21859736 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background. Neutropenic patients are at risk for abdominal complications, yet their incidence and impact on patient morbidity and mortality has 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 at seven German hematology-oncology departments. For inclusion, neutropenia of at least five 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 C) and abdominal pain and/or lack of bowel movement for ≥72 hours. 521 neutropenic episodes of 359 patients were documented. Results. The incidence of chemotherapy associated bowel syndrome was 126/359 (35%) in first episodes. 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 patient 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. The trial was registered at the German Clinical Trials Register (ID: DRKS00000111). |
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Authors:
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Maria J G T Vehreschild; Arne Meissner; Oliver Andreas Cornely; Georg Maschmeyer; Silke Neumann; Marie von Lilienfeld-Toal; Meinholf Karthaus; Mohammed Wattad; Peter Staib; Martin Hellmich; Hildegard Christ; Jörg-Janne Vehreschild |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-22 |
Journal Detail:
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Title: Haematologica Volume: - ISSN: 1592-8721 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Germany; |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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