Infectious Disease Book

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Clinical Index of Stable Febrile Neutropenia

Aka: Clinical Index of Stable Febrile Neutropenia, CISNE Score
  1. See Also
    1. Neutropenic Fever
    2. Neutropenia
    3. MASCC Risk Index
  2. Indications
    1. Assess risk in Neutropenic Fever
  3. Contraindications
    1. Age <18 years old
    2. Hospitalization for other reason (e.g. PE, arrhythmia)
    3. Acute organ failure or decompensation of chronic insufficiency (e.g. Renal Failure, respiratory failure, CHF)
    4. Shock or Hypotension with systolic Blood Pressure <90 mmHg
    5. Severe infection
  4. Criteria
    1. Score 2: Eastern Cooperative Oncology Group Performance Score (ECOG Performance Status) >2
    2. Score 2: Stress induced Hyperglycemia
    3. Score 1: COPD
    4. Score 1: Chronic cardiovascular disease
    5. Score 1: NCI Mucositis >2
      1. Patchy ulcerations or pseudomembranes
      2. Moderate pain requiring modified diet
    6. Score 1: Monocyte Count <200/mm3
  5. Interpretation
    1. Total 0: Low risk of complications
    2. Total 1-2: Moderate Risk of complications
    3. Total >2: High Risk of complications
  6. Efficacy
    1. Test Specificity: Approaches 100% for identifying low risk patients
  7. References
    1. Carmona-Bayona (2015) J Clin Oncol 33:465-71 [PubMed]

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