Systematic review of case reports concerning adults suffering from neutropenic enterocolitis

Revista Colombiana de Cancerología

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Title Systematic review of case reports concerning adults suffering from neutropenic enterocolitis
Enterocolitis neutropénica: revisión sistemática de casos publicados
 
Creator Cardona, Andrés Felipe
Reveiz, Ludovic
Ospina, Edgar Guillermo
Casasbuenas, Alexandra
Aponte, Diego Mauricio
Ramos, Pedro
 
Subject Enterocolitis
neutropenic
systematic review
colitis
necrotizing enterocolitis
Enterocolitis neutropénica
revisión sistemática
colitis
enterocolitis
necrotizante
 
Description Introduction: Neutropenic enterocolitis (NEC) is a well recognised clinical-pathological and life-threatening complication in patients suffering from several conditions, including solid and haematological malignancies or aplastic anaemia. Objective: This review was aimed at evaluating overall NEC mortality rate, describing clinical diagnostic findings and therapeutical interventions reported in the literature and generating a hypothesis regarding factors influencing mortality and surgical intervention.Materials and methods: An advanced search was made in Medline, Embase, Lilacs and Google. Additional strategies included manual search of specific journals. Reports were considered if they described case definition, inclusion and exclusion criteria.Results: 275 cases were selected; 109 were from individual data and 40 from grouped data. Comparing data between case reports and case series revealed no significant differences related to mortality, surgical intervention, sex or age. Higher mortality (x2=7.51 p=0.006) was found in women (50%) compared to men (28%). No significant difference was found between antibiotic combinations and mortality (x2=12.85 df 13 p=0.45). Mortality (x2=3.89 df 1, p=0.049), surgical intervention (x2=7.64 df 1, p=0.006) and duration of diarrhoea (x2=4.71 df 1, p=0.043) were significantly different in 26.4% of individuals using antifungal agents; death occurred in 81% of patients who did not receive such medication compared to 19% individuals reported as being treated with antifungal agents.Conclusion:The current evidence suggests that antifungal agents should be used early in patients suffering from NEC. However, this hypothesis must be evaluated in multi-centric, randomised controlled trials.
Introducción: La enterocolitis neutropénica (ECN) es una entidad clínico patológica bien reconocida que amenaza habitualmente la vida y se asocia con diversas neoplasias sólidas y hematológicas y con la anemia aplásica.Objetivo: Evaluar la mortalidad global de la ECN, describir los hallazgos clínicos más frecuentes y las intervenciones terapéuticas reportadas en la literatura médica, con la finalidad de generar hipótesis acerca de los factores que influyen sobre la mortalidad y en la realización de intervenciones quirúrgicas.Materiales y métodos: Se realizaron búsquedas avanzadas en las bases de datos Medline, Embase, Lilacs y en el motor general Google; además, se utilizaron como estrategias adicionales, búsquedas manuales en diversas revistas. Los reportes fueron considerados según la definición del caso teniendo en cuenta criterios específicos para inclusión y exclusión.Resultados: Se seleccionaron 228 casos; 109 fueron casos individuales y 40 reportes correspondieron a series de casos. La comparación de los datos obtenidos a partir de los reportes individuales y de las series de casos no reveló diferencias significativas respecto de la mortalidad, intervenciones quirúrgicas, edad y sexo. Se encontró una mortalidad mayor en las mujeres (x2=7,51 p=0,006) comparadas con los hombres (50% vs. 28%). No se identificaron diferencias significativas entre las combinaciones de antibióticos respecto de la mortalidad (x2= 12,85 df 13 p=0,45). La mortalidad (x2=3,89 df 1, p=0,049), las intervenciones quirúrgicas (x2=7,64 df 1, p=0,006) y la duración de la diarrea (x2=4,71 df 1, p=0,043) fueron significativamente diferentes en el 26,4% de los individuos que fueron tratados con antifúngicos; el 81 % de los pacientes que no recibieron estos medicamentos murieron, en comparación con el 19% de los sujetos en que se reportó la utilización de antimicóticos. Conclusión: La evidencia sugiere que los agentes antifúngicos deben ser usados tempranamente en los pacientes que padecen ECN. Sin embargo, esta hipótesis debe ser evaluada en experimentos clínicos multicentricos con asignación aleatoria.
 
Publisher Instituto Nacional de Cancerología
 
Date 2005-09-01
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
 
Identifier https://www.revistacancercol.org/index.php/cancer/article/view/604
 
Source Revista Colombiana de Cancerología; Vol. 9 No. 3 (2005); 82-92
Revista Colombiana de Cancerología; Vol. 9 Núm. 3 (2005); 82-92
Revista Colombiana de Cancerología; v. 9 n. 3 (2005); 82-92
2346-0199
0123-9015
 
Language spa
 
Relation https://www.revistacancercol.org/index.php/cancer/article/view/604/420
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