cisne_score: Clinical Index of Stable Febrile Neutropenia (CISNE)

In cliot: Clinical Indices and Outcomes Tools

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)

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).

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.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.