Use of Scores in Risk Stratification of Febrile Neutropenia-A Scoping Review

Purpose: A scoping review of the published risk stratification scores for febrile neutropenia (FN) was performed to provide a basis for further research and optimization of risk stratification models that can support evidence-based clinical decision-making with a combined individual patient and health resource perspective. Methods: The scoping review utilized the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR). Studies reporting risk stratification models for FN and published in the PubMed and/or Scopus databases between 2000 and 2024 were retrieved and reviewed. Study eligibility criteria were adult cancer patients and articles utilizing FN risk stratification methods. Two researchers reviewed all relevant studies separately to determine if they were eligible for inclusion and extracted the necessary data. Results: A total of 210 papers was screened by title and abstract. A further 158 were screened by retrieval and eligibility, and 14 studies were found eligible after reviewing full papers. Studies have different cohort sizes (min 31, max 4434), age and gender distributions, cancer types (1 hematological, 3 gynecological, 10 mixtures of hematological and solid cancers), definitions of FN and complication, study type (2 retrospective, 12 prospective). The resulting papers mostly focused on validating CISNE and MASCC scores. Additionally, they investigated possible improvements by evaluating revised versions of the MASCC score. Conclusions: The scoping review revealed inconsistencies in key definitions when using risk stratification scores. It is concluded that the field could benefit from more consensus in definitions and research approaches to secure the generalizability and utility of the research.