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Abstract
Background: Febrile neutropenia (FN) remains a high-acuity complication of myelosuppressive chemotherapy, yet outcomes in Hispanic patients—particularly in South Texas—are underrepresented. We compared outcomes of FN admissions among Hispanic adults with solid tumors versus hematologic malignancies at a community hospital in the Rio Grande Valley.
Methods: We conducted a retrospective cohort study of adult hospital admissions for FN from January 2022 through January 2025. Inclusion criteria were age ≥18 years, FN documented in the emergency department, active chemotherapy for a solid or hematologic malignancy, and Hispanic ethnicity. Of 139 charts screened, 97 met criteria (46 solid tumors; 51 hematologic malignancies). Primary outcomes were ICU admission, in-hospital mortality, and hospital length of stay (LOS). Secondary analyses evaluated time-to-antibiotics (TTA; minutes from ED arrival to first IV antibiotic) and neutropenia severity using absolute neutrophil count (ANC) at presentation. Baseline characteristics were summarized descriptively. ICU admission and mortality were compared using crude odds ratios and ridge (L2)-penalized logistic regression adjusted for age and sex with bootstrap 95% CIs. LOS was compared using the Mann–Whitney U test and modeled as log, reported as adjusted percent differences.
Results: Patients with hematologic malignancies were younger and more often male; comorbidity profiles were otherwise similar. ICU admission occurred in 32.6% of solid tumor admissions versus 25.5% of hematologic admissions (adjusted OR 0.75; 95% CI 0.29–1.94). In-hospital mortality occurred in 21.7% versus 9.8%, respectively (adjusted OR 0.39; 95% CI 0.11–1.45). Median LOS was 4.0 days [IQR 3.0–6.75] for solid tumors and 5.0 days [3.0–6.0] for hematologic malignancies (p=0.71); the adjusted difference was −2.1% (95% CI −21.6% to +22.3%). TTA was rapid overall (median 15 minutes [10–28]). Within this already short window, longer TTA was not associated with ICU admission, mortality, or LOS in adjusted models; the negative unadjusted correlations likely reflected confounding by indication (sicker patients received antibiotics sooner). Lower ANC at arrival correlated with higher ICU use (r=−0.21, p=0.035) and longer LOS (ρ=−0.25, p=0.012), but not mortality.
Conclusions: In this Hispanic cohort hospitalized for FN and treated through the same ED sepsis pathway, outcomes were similar between solid and hematologic malignancies, with no meaningful differences in ICU admission, mortality, or LOS after basic adjustment. Cancer type alone may be less informative than physiologic severity at presentation: lower ANC aligned with greater ICU utilization and longer LOS. These findings support maintaining uniform, rapid-response FN protocols in this setting and focusing future prospective work on severity metrics, microbiology, and treatment context.
Recommended Citation
Peddinani, Bharat K.; Calderon, Aura; Elizondo-Romo, Ramon; Mills-Reyes, Elizabeth; and Cobos, Everardo, "Clinical Outcomes in Neutropenic Fever at a South Texas Community Hospital in Hispanic Patients." (2026). Research Symposium. 6.
https://scholarworks.utrgv.edu/somrs/2026/talks/6
Included in
Clinical Outcomes in Neutropenic Fever at a South Texas Community Hospital in Hispanic Patients.
Background: Febrile neutropenia (FN) remains a high-acuity complication of myelosuppressive chemotherapy, yet outcomes in Hispanic patients—particularly in South Texas—are underrepresented. We compared outcomes of FN admissions among Hispanic adults with solid tumors versus hematologic malignancies at a community hospital in the Rio Grande Valley.
Methods: We conducted a retrospective cohort study of adult hospital admissions for FN from January 2022 through January 2025. Inclusion criteria were age ≥18 years, FN documented in the emergency department, active chemotherapy for a solid or hematologic malignancy, and Hispanic ethnicity. Of 139 charts screened, 97 met criteria (46 solid tumors; 51 hematologic malignancies). Primary outcomes were ICU admission, in-hospital mortality, and hospital length of stay (LOS). Secondary analyses evaluated time-to-antibiotics (TTA; minutes from ED arrival to first IV antibiotic) and neutropenia severity using absolute neutrophil count (ANC) at presentation. Baseline characteristics were summarized descriptively. ICU admission and mortality were compared using crude odds ratios and ridge (L2)-penalized logistic regression adjusted for age and sex with bootstrap 95% CIs. LOS was compared using the Mann–Whitney U test and modeled as log, reported as adjusted percent differences.
Results: Patients with hematologic malignancies were younger and more often male; comorbidity profiles were otherwise similar. ICU admission occurred in 32.6% of solid tumor admissions versus 25.5% of hematologic admissions (adjusted OR 0.75; 95% CI 0.29–1.94). In-hospital mortality occurred in 21.7% versus 9.8%, respectively (adjusted OR 0.39; 95% CI 0.11–1.45). Median LOS was 4.0 days [IQR 3.0–6.75] for solid tumors and 5.0 days [3.0–6.0] for hematologic malignancies (p=0.71); the adjusted difference was −2.1% (95% CI −21.6% to +22.3%). TTA was rapid overall (median 15 minutes [10–28]). Within this already short window, longer TTA was not associated with ICU admission, mortality, or LOS in adjusted models; the negative unadjusted correlations likely reflected confounding by indication (sicker patients received antibiotics sooner). Lower ANC at arrival correlated with higher ICU use (r=−0.21, p=0.035) and longer LOS (ρ=−0.25, p=0.012), but not mortality.
Conclusions: In this Hispanic cohort hospitalized for FN and treated through the same ED sepsis pathway, outcomes were similar between solid and hematologic malignancies, with no meaningful differences in ICU admission, mortality, or LOS after basic adjustment. Cancer type alone may be less informative than physiologic severity at presentation: lower ANC aligned with greater ICU utilization and longer LOS. These findings support maintaining uniform, rapid-response FN protocols in this setting and focusing future prospective work on severity metrics, microbiology, and treatment context.
