Data Collection
Demographic information, degree of neutropenia (ANC < 500 or > 500 cells/µL), absolute monocyte count (AMC), presence of GI symptoms, chills/rigors, severe mucositis, hypotension, and evidence of focal infection were collected. Blood culture results, amount/timing of acetaminophen doses, patient temperatures 1-, 2-, and 6-hours after acetaminophen, timing of antibiotic initiation and presence of antibiotic prophylaxis prior to presentation were also examined. Temperature measurements within 30 minutes of the 1-, 2-, and 6-hour time points were used for post-acetaminophen temperature documentation.
Patients were stratified into one of three malignancy categories: leukemia/lymphoma, solid tumor, and hematopoietic stem cell transplant (HSCT). Each patient was paired with a matched control using sex, age, category of malignancy and degree of neutropenia. Controls were identified as patients with documentation of FN and negative blood cultures on admission. Sixteen patients (46%) served as their own control using data from a separate culture negative admission for FN. Prior to cohort assembly a power analysis determined that data from 70 presentations of FN (35 cohort and 35 controls) were necessary to demonstration a meaningful temperature change of 1°F or 0.56°C after acetaminophen administration at a power of 80%.