• Minsoo Kim, Shin Ahn, Won Young Kim, Chang Hwan Sohn, Dong Woo Seo, Yoon-Seon Lee, and Kyung Soo Lim.
• College of Medicine, Cancer Emergency Room, Department of Emergency Medicine, Asan Medical Center, University of Ulsan, 388-1, Pungnap-dong, Songpa-gu, Seoul, 138-736, South Korea.
• Support Care Cancer. 2017 May 1; 25 (5): 1557-1562.

PurposeIn Sepsis-3, the quick Sequential Organ Failure Assessment (qSOFA) score was developed as criteria to use for recognizing patients who may have poor outcomes. This study was performed to evaluate the predictive performance of the qSOFA score as a screening tool for sepsis, mortality, and intensive care unit (ICU) admission in patients with febrile neutropenia (FN). We also tried to compare its performance with that of the systemic inflammatory response syndrome (SIRS) criteria and Multinational Association of Supportive Care in Cancer (MASCC) score for FN.MethodsWe used a prospectively collected adult FN data registry. The qSOFA and SIRS scores were calculated retrospectively using the preexisting data. The primary outcome was the development of sepsis. The secondary outcomes were ICU admission and 28-day mortality.ResultsOf the 615 patients, 100 developed sepsis, 20 died, and 38 were admitted to ICUs. In multivariate analysis, qSOFA was an independent factor predicting sepsis and ICU admission. However, compared to the MASCC score, the area under the receiver operating curve of qSOFA was lower. qSOFA showed a low sensitivity (0.14, 0.2, and 0.23) but high specificity (0.98, 0.97, and 0.97) in predicting sepsis, 28-day mortality, and ICU admission.ConclusionsPerformance of the qSOFA score was inferior to that of the MASCC score. The preexisting risk stratification tool is more useful for predicting outcomes in patients with FN.

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