Therese Lindberg

therese.lindberg@cambio.se

Cambio CDS

Identifies febrile neutropenia patients at low risk of serious complications. CISNE is more specific than the MASCC Risk Index.

Use in adult outpatients at least 18 years old with solid tumor, fever at least 38°C (100.4°F) over 1 hr, and neutropenia (500 cells/mm³or fewer, or 1,000 cells/mm³ with expected decrease to 500). The index is calculated from 6 parameters: ECOG Performance status, Stress-induced hyperglycemia, COPD, Cardiovasculat disease history, NCI mucositis grade ≥2 and Monocytes. Interpretation: CISNE: Risk category: Risk of complications: Recommendation: 0 I (Low) 1.1% Consider discharge with oral antibiotics after discussion with oncology. 1-2 II (Intermediate) 6.2% Use clinical judgment regarding admission. Consider oncology consultation. ≥3 III (High) 36% Admit for further investigation, including blood cultures.

Do not use in patients with acute organ failure, severe infection, hypotension, or other reason for admission.

1. Carmona-bayonas A, Gómez J, González-billalabeitia E, et al. Prognostic evaluation of febrile neutropenia in apparently stable adult cancer patients. Br J Cancer. 2011;105(5):612-7.

OBSERVATION.lab_test-full_blood_count.v1, OBSERVATION.ecog_performance_status.v1, EVALUATION.cisne.v0