Calculateur du score brut MASCC original de 2000 pour la neutropénie fébrile

État

clinical-review-pending

Version de la méthode

Klastersky et al. original 2000 MASCC febrile-neutropenia arithmetic, engine mascc-febrile-neutropenia-score-2000-v1: burden selected at the initial fever presentation by a qualified clinician contributes 5 for no-or-mild symptoms, 3 for moderate symptoms, and 0 for severe symptoms or moribund; the burden categories are mutually exclusive and never cumulative. Add 5 when source-defined hypotension is absent; 4 when source-defined active COPD is absent; 4 for the primary source category solid tumor or lymphoma, or for the other-hematologic-tumor category only when previous fungal infection is absent; 3 when dehydration requiring IV therapy is absent; 3 when fever began while the patient was an outpatient; and 2 only when completed age is <60 years. Exact age 60 contributes 0. The result is the unrounded integer sum from 0 through 26. Inputs must be complete, clinician verified, and assessed at the same initial fever presentation. The primary candidate table defines hypotension as systolic blood pressure <90 mmHg, while later adapted tables print no hypotension as >90 mmHg; exact 90 is therefore a documented source-wording conflict. This workflow accepts only a qualified clinician-attested source-defined hypotension category after review of presentation hemodynamics and pressor context and supplies no raw-blood-pressure classifier. The legacy MASCC explanatory table also reverses the age row to >60 for 2 points; this implementation follows the primary publication's age <60 component. Eleven independent confirmations cover adult original-source applicability; malignancy chemotherapy causative or contributive to the current neutropenia; documented oral temperature >38 C; granulocytes including polymorphonuclear cells and bands <500/µL; one complete initial presentation; direct qualified-clinician source-category selection; review of primary definitions and known source variants; independent confirmation of an appropriate initial empiric antibacterial regimen; acknowledgement that immediate empiric antibacterial care was not delayed; acknowledgement that the raw result will not be used alone for disposition or treatment; and historical-to-current-era transport. Output is limited to version, raw 0–26 integer, seven component contributions, and exact entered-value audit; no cutoff or threshold, risk class or adjective, complication probability, outcome, mortality, prognosis, diagnosis, admission or discharge decision, outpatient eligibility, antibiotic or other treatment advice, monitoring, disposition, management, or recommendation is supplied.

Population

Qualified clinicians calculating the frozen original 2000 arithmetic for an adult age 18 years or older with independently established malignancy treated by chemotherapy causative of or contributive to the current neutropenia, documented oral temperature >38 C, and granulocytes including polymorphonuclear cells and bands <500/µL, using one complete initial fever-presentation assessment after independent confirmation of an appropriate initial empiric antibacterial regimen and without delaying immediate empiric antibacterial evaluation or care. The prospective source registered 1,351 patients from December 1994 through November 1997 at 20 institutions in 15 countries, excluded 212, and analyzed the first eligible episode for 1,139 patients; institutions rather than patients allocated 756 to derivation and 383 to validation. The final multivariable model used 746 derivation records because 10 lacked burden-of-illness data. Median age was 52 years and the reported range was 16–91; 174 patients underwent bone-marrow transplantation and 574 were inpatients at fever onset. The original eligibility prose says age >16 while the reported range includes 16 and exclusions say age <16; age >=18 is deliberately narrower product scope. Current use is transport from a 1994–1997 cohort and neither the raw arithmetic nor its record replaces urgent care or clinical judgment.

Limites et exclusions

Pediatric use; neutropenia unrelated to chemotherapy or malignancy; afebrile neutropenia; non-oral or undocumented fever for source-eligibility confirmation; granulocytes not established below 500/µL; prophylaxis-only use; a post-resolution, later, different, retrospective, or mixed-timepoint episode; or use to establish febrile neutropenia, malignancy, chemotherapy causality, source applicability, or the appropriateness of the initial empiric antibacterial regimen. · Missing, unknown, inferred, imputed, defaulted, carried-forward, or incomplete inputs; patient- or caregiver-selected burden; burden derived from a symptom checklist, ECOG, KPS, PPS, Lansky, fever, vitals, infection site, or symptom count; current location substituted for setting at fever onset; an unsupported malignancy or fungal-history mapping; a previous-fungal-infection field applied to the solid-tumor-or-lymphoma branch; a six-month antifungal-therapy shortcut; inactive or history-only COPD automatically counted as active; or dehydration detached from the source IV-therapy requirement. · Automatic classification from raw systolic blood pressure or pressor fields, especially exact 90 mmHg, rather than a qualified clinician resolving the primary-versus-later-table wording conflict; accepting >90 as the frozen primary boundary; awarding two points at age 60 or older; summing no-or-mild and moderate burden points; awarding burden points for severe-or-moribund status; or any change to the source-locked primary malignancy branch, component weights, timing, or arithmetic. · Any cutoff or threshold including 21; a risk group or adjective; complication, mortality, or other outcome probability; individual prognosis; diagnosis; admission, discharge, outpatient eligibility, or other disposition; antimicrobial timing or selection; treatment; monitoring; management; recommendation; or use as a replacement for urgent assessment or clinical judgment. CISNE, Talcott, pediatric or Lansky models, conversions, and combined models remain separate and are not calculated. · Verbatim or adapted reproduction or translation of the ASCO article or source table without permission; MASCC, ASCO, or JCO logo, visual identity, official-looking branding, affiliation, or endorsement. MASCC is used nominatively only; the independently expressed factual arithmetic and labels are the implementation basis. The primary article is ASCO-copyrighted and MASCC branding requires separate permission; clinical and legal review remain pending.

• https://pubmed.ncbi.nlm.nih.gov/10944139/
• https://doi.org/10.1200/JCO.2000.18.16.3038
• https://ascopubs.org/doi/abs/10.1200/JCO.2000.18.16.3038
• https://mascc.memberclicks.net/index.php?day=22&id=25%3Aidentifying-patients-at-low-risk-for-fn-complications-development-and-validation-of-the-mascc-risk-index-score&month=01&option=com_dailyplanetblog&view=entry&year=2015
• https://academic.oup.com/cid/article/52/4/e56/382256
• https://www.idsociety.org/practice-guideline/neutropenic-patients-with-cancer/
• https://ascopubs.org/doi/abs/10.1200/JCO.2017.77.6211
• https://www.idsociety.org/globalassets/idsa/practice-guidelines/outpatient-management-of-fever-and-neutropenia.pdf
• https://doi.org/10.1111/imj.70251
• https://www.eviq.org.au/clinical-resources/oncological-emergencies/123-neutropenic-fever-patient-evaluation-risk-as
• https://www.asco.org/about-asco/legal/copyright-permission
• https://mascc.org/about-mascc/branding-center/

Outil importé de la bibliothèque PharmaTek de MDose. Aucune date de révision clinique indépendante n’est documentée dans cette version.

Bibliothèque source

PharmaTek · MDose

Version importée

4b66536936ed

État de publication

Révision clinique en cours