Online Articles: Original ArticlesWhich Variables Are Useful for Predicting Severe Infection in Children With Febrile Neutropenia?Delebarre, Mathilde MD, MSc*,†,‡; Garnier, Nathalie MD‡; Macher, Emilie MD‡; Thebaud, Estelle MD§; Mazingue, Françoise MD‡; Leblond, Pierre MD, PhD§; Duhamel, Alain MD, PhD*,†,∥; Martinot, Alain MD*,†,¶; Dubos, François MD, PhD*,†,¶Author Information *Lille-2 University and EA2694, Public Health, Epidemiology and Quality of Care †UDSL ‡Centre Hospitalier Régional Universitaire, CHRU Lille, Pediatric Hematology Unit §Pediatric Oncology Unit, Oscar Lambret Cancer Centre ∥CERIM (EA2694), Lille-2 University ¶Centre Hospitalier Régional Universitaire, CHRU Lille, Pediatric Emergency and Infectious Diseases Unit, Lille, France The authors declare no conflict of interest. Reprints: François Dubos, MD, PhD, Hôpital R. Salengro, CHRU Lille, 2, av. Oscar Lambret, 59000 Lille, France (e-mail: email@example.com). Received March 24, 2015 Accepted August 29, 2015 Journal of Pediatric Hematology/Oncology: November 2015 - Volume 37 - Issue 8 - p e468-e474 doi: 10.1097/MPH.0000000000000440 Buy Metrics Abstract To distinguish children with chemotherapy-induced febrile neutropenia (FN) at low risk of severe infection, the variables that are significant risk factors must be identified. Our objective was to identify them by applying evidence-based standards. This retrospective 2-center cohort study included all episodes of chemotherapy-induced FN in children in 2005 and 2006. The medical history, clinical, and laboratory data available at admission were collected. Severe infection was defined by bacteremia, a positive culture of a normally sterile body fluid, invasive fungal infection, or localized infection at high risk of extension. Univariate analysis identified potential predictive variables. A generalized mixed model was used to determine the adjusted variables that predict severe infection. We analyzed 372 FN episodes. Severe infections occurred in 16.1% of them. Variables predictive of severe infection at admission were: disease with high risk of prolonged neutropenia (adjusted odds ratio [aOR]=2.5), blood cancer (aOR=1.9), fever ≥38.5°C (aOR=3.7), and C-reactive protein level ≥90 mg/L (aOR=4.5). Now that we have identified these variables significantly associated with the risk of severe infection, they must be validated prospectively before combining the best predictive variables in a decision rule that can be used to distinguish children at low risk. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.