The epidemiology and outcomes of adult cancer patients with suspected neutropenic fever in the emergency department

doi:10.5847/wjem.j.1920-8642.2026.052

World Journal of Emergency Medicine ›› 2026, Vol. 17 ›› Issue (3): 258-261.doi: 10.5847/wjem.j.1920-8642.2026.052

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The epidemiology and outcomes of adult cancer patients with suspected neutropenic fever in the emergency department

Shi Yeow Lee¹, Rex Pui Kin Lam¹^,², Siu Chung Leung¹, Yan Yiu Yu¹, Tat Chi Tsang², Rock Yuk Yan Leung³, Chung Yan Joanne Leung¹, Michael Chun Kai Lau¹, Timothy Hudson Rainer¹()

¹ Department of Emergency Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China
² Accident and Emergency Department, Queen Mary Hospital, Hong Kong, China
³ Department of Pathology, Queen Mary Hospital, Hong Kong, China

Received:2026-01-27 Accepted:2026-04-22 Online:2026-05-19 Published:2026-05-01
Contact: Timothy Hudson Rainer, Email: thrainer@hku.hk

Abstract

Shi Yeow Lee, Rex Pui Kin Lam, Siu Chung Leung, Yan Yiu Yu, Tat Chi Tsang, Rock Yuk Yan Leung, Chung Yan Joanne Leung, Michael Chun Kai Lau, Timothy Hudson Rainer. The epidemiology and outcomes of adult cancer patients with suspected neutropenic fever in the emergency department[J]. World Journal of Emergency Medicine, 2026, 17(3): 258-261.

Figures/Tables 1

Table 1.

Demographic and clinical characteristics of patients with suspected neutropenic fever

Variables	Entire cohort (n=598)	NF subgroup (n=142)	Non-NF subgroup (n=456)	P-value
Age, years, median (IQR)	62.0 (53.0-72.0)	62.5 (53.0-72.0)	62.0 (53.0-72.0)	0.90
Sex, n (%)
Female	312 (52.2)	74 (52.1)	238 (52.2)	0.99
Male	286 (47.8)	68 (47.9)	218 (47.8)
Type of cancer, n (%)*
Hematologic malignancies	243 (40.6)	99 (69.7)	144 (31.6)	<0.001
Leukemia	123 (20.6)	55 (38.7)	68 (14.9)	<0.001
Lymphoma	64 (10.7)	19 (13.4)	45 (9.9)	0.24
Multiple myeloma	16 (2.7)	6 (4.2)	10 (2.2)	0.23
Others	52 (8.7)	26 (18.3)	26 (5.7)	<0.001
Solid tumor	381 (63.7)	51 (35.9)	330 (72.4)	<0.001
Gastrointestinal cancer	91 (15.2)	15 (10.6)	76 (16.7)	0.08
Breast cancer	72 (12.0)	15 (10.6)	57 (12.5)	0.54
Hepatobiliary cancer	65 (10.9)	2 (1.4)	63 (13.8)	<0.001
Lung cancer	59 (9.9)	3 (2.1)	56 (12.3)	<0.001
Gynecological cancer	41 (6.9)	7 (4.9)	34 (7.5)	0.30
Urological cancer	25 (4.2)	2 (1.4)	23 (5.0)	0.06
Others	46 (7.7)	8 (5.6)	38 (8.3)	0.29
Charlson Comorbidity Index, median (IQR)	6 (4-8)	5 (3-6)	7 (4-8)	<0.001
ANC on presentation, n (%)
≥1.0×10⁹/L	456 (76.3)	0 (0)	456 (100)	<0.001
≥0.5 to 1.0×10⁹/L	30 (5.0)	30 (21.1)	0 (0)
<0.5×10⁹/L	112 (18.7)	112 (78.9)	0 (0)
MEWS, median (IQR)	3 (2-4)	3 (2-4)	3 (2-4)	0.75
Antibiotic use, n (%)
Meropenem	557 (93.1)	128 (90.1)	429 (94.1)	0.11
Levofloxacin	29 (4.8)	7 (4.9)	22 (4.8)	0.96
Amikacin	7 (1.2)	5 (3.5)	2 (0.4)	0.01
Meropenem and amikacin	5 (0.8)	2 (1.4)	3 (0.7)	0.34
Door-to-antibiotic time, min, median (IQR)	30.5 (24.0-40.0)	31.0 (25.0-41.0)	30.0 (24.0-40.0)	0.47
Antibiotic within 1 h, n (%)	575 (96.2)	138 (97.2)	437 (95.8)	0.47
Sepsis within 48 h, n (%)	70 (11.7)	20 (14.1)	50 (11.0)	0.31
Septic shock within 48 h, n (%)	8 (1.3)	3 (2.1)	5 (1.1)	0.40
Need for inotrope, n (%)	12 (2.0)	3 (2.1)	9 (2.0)	>0.99
Need for assisted ventilation, n (%)	5 (0.8)	1 (0.7)	4 (0.9)	>0.99
ICU admission, n (%)	9 (1.5)	2 (1.4)	7 (1.5)	>0.99
Length of hospital stay, d, median (IQR)	4.0 (2.0-7.0)	4.0 (2.8-8.0)	4.0 (2.0-7.0)	0.02
All-cause mortality, n (%)
2 d	7 (1.2)	3 (2.1)	4 (0.9)	0.37
7 d	15 (2.5)	7 (4.9)	8 (1.8)	0.06
30 d	57 (9.5)	15 (10.6)	42 (9.2)	0.63
90 d	127 (21.2)	33 (23.2)	94 (20.6)	0.50

Table 1.

References 10

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The epidemiology and outcomes of adult cancer patients with suspected neutropenic fever in the emergency department

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