Clinical calculator summary
MASCC Febrile Neutropenia Risk Index
Clinical calculator summary
MASCC Febrile Neutropenia Risk Index
A complication-risk index for adults presenting with febrile neutropenia.
Evidence-based context for fast calculator use
- Purpose:
- Identify patients who may be low risk after urgent febrile-neutropenia assessment
- Population:
- Adults with treatment-related febrile neutropenia after immediate clinical stabilization and infection assessment
- Factors:
- Illness burden, Hypotension, COPD, Tumor type, Dehydration, Outpatient status, Age
- Reference:
- Klastersky et al., J Clin Oncol. 2000
MASCC Risk Index
Clinical Context & Background
MASCC = illness burden (5/3/0) + SBP >90 (5) + no COPD (4) + solid tumor or hematologic malignancy without previous fungal infection (4) + no dehydration requiring parenteral fluids (3) + outpatient fever onset (3) + age <60 (2). Maximum 26; ≥21 is the lower-risk group.Reference Data
| Risk Group | Score | Interpretation |
|---|---|---|
| Low Risk | ≥21 | Lower model-predicted complication risk; complete separate clinical and logistical eligibility assessment. |
| High Risk | <21 | Not in the lower-risk group; urgent inpatient clinical management pathway. |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use during initial febrile-neutropenia assessment after urgent observations, sepsis evaluation, cultures, and empiric-antibiotic planning.
- Use only when the patient and clinical setting match the population described for MASCC Febrile Neutropenia Risk Index.
How To Interpret
- A score of 21 or more identifies a lower complication-risk group but does not by itself establish outpatient safety.
- Interpret thresholds with the entered units, current clinical status, and local guideline context.
What To Do Next
- Confirm clinical stability, oral intake, organ function, social support, travel time, follow-up access, and local antimicrobial pathway.
- Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.
Limitations
- Never delay empiric antibiotics or override sepsis physiology because of a favorable score.
- This calculator supports clinical assessment and does not independently prescribe treatment.
Validated Population
Adults with treatment-related febrile neutropenia after immediate clinical stabilization and infection assessment
Clinical example
A MASCC score of 21 or more in a stable patient supports outpatient-pathway consideration only after all clinical and logistical exclusion criteria are checked.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed MASCC cases passed through visible production controls at scores 26, exact cutoff 21, and 20.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/mascc-febrile-neutropenia-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/mascc-febrile-neutropenia.json.
: Input workflow simplified and revalidated
- Reduced the public form to result-, branch-, unit-, and applicability-changing inputs; removed or consolidated non-scoring, administrative, and duplicate questions.
- Preserved the verified calculation or report-interpretation logic, thresholds, model version, component logic, and supported result pathways behind strict deterministic adapters.
- Passed the calculator-specific regression audit, adapter-parity and malformed-input checks, the 144-calculator input-quality audit, and the 43-calculator entry-burden audit.
: Full validation test
- Passed 69/69 score, cutoff, age, blood-pressure, predictor, applicability, missing-input, and malformed-input checks.
- Confirmed maximum 26 and the published lower-risk cutoff at 21 points.
: Correction
- Replaced favorable pre-scored defaults with required raw age, systolic blood pressure, illness burden, clinical context, and explicit binary inputs.
- Corrected the hematologic-malignancy item to depend on previous fungal infection and clarified clinician-rated illness burden.
- Removed the unsupported less-than-5-percent claim and automatic outpatient, oral-antibiotic, admission, and IV-antibiotic directives from the score result.
- Added an overriding warning when hypotension or severe illness coexists with an arithmetic score of 21 or more.
Included in the current validation report.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
What is MASCC Febrile Neutropenia Risk Index used for?
Identify patients who may be low risk after urgent febrile-neutropenia assessment. It is intended for adults with treatment-related febrile neutropenia after immediate clinical stabilization and infection assessment.
Does MASCC Febrile Neutropenia Risk Index determine treatment by itself?
No. Confirm the population, inputs, contraindications, competing risks, and current guideline recommendations before acting on the result.
Evidence-based oncology decision support. Verify with clinical guidelines.