cliot (version 1.0.0)

cisne_score: Clinical Index of Stable Febrile Neutropenia (CISNE)

Description

Calculates the CISNE score to predict the risk of serious complications (e.g., hypotension, organ failure, major bleeding) in patients with solid tumors presenting with apparently stable febrile neutropenia. This tool helps identify low-risk patients who may be candidates for outpatient management.

Usage

cisne_score(ecog_ge_2, copd, cvd, mucositis_ge_2, monocytes_lt_200,
            stress_hyperglycemia)

Value

A list containing:

CISNE_Score

The calculated score (Range 0-8).

Risk_Class

Classification (Low: 0, Intermediate: 1-2, High: >=3).

Est_Serious_Complication_Rate

Estimated percentage risk of serious complications.

Recommendation

Guidance on inpatient vs. outpatient management.

Arguments

ecog_ge_2

Numeric (0 or 1). ECOG Performance Status >= 2. (1 = Yes, +2 points).

copd

Numeric (0 or 1). Chronic Obstructive Pulmonary Disease. (1 = Yes, +1 point).

cvd

Numeric (0 or 1). Chronic Cardiovascular Disease (e.g., history of MI, heart failure). (1 = Yes, +1 point).

mucositis_ge_2

Numeric (0 or 1). Mucositis NCI Grade >= 2 (moderate to severe). (1 = Yes, +1 point).

monocytes_lt_200

Numeric (0 or 1). Monocytes < 200 per uL. (1 = Yes, +1 point).

stress_hyperglycemia

Numeric (0 or 1). Stress-induced hyperglycemia (defined as glucose > 120 mg/dL in absence of diabetes, or patient has history of diabetes). (1 = Yes, +2 points).

References

Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia (CISNE). J Clin Oncol. 2015;33(5):465-471. doi:10.1200/JCO.2014.57.2347

Examples

# Example 1: High Risk
# ECOG 2 (+2), Diabetes/Hyperglycemia (+2)
# Score = 4
cisne_score(1, 0, 0, 0, 0, 1)

# Example 2: Low Risk
# No risk factors present
# Score = 0
cisne_score(0, 0, 0, 0, 0, 0)