The MASCC Risk Index (Multinational Association for Supportive Care in Cancer Risk Index) is a widely validated clinical scoring system designed to stratify adult cancer patients with chemotherapy-induced febrile neutropenia (FN) into low-risk and high-risk categories for serious medical complications. Developed by the MASCC, the index is a crucial tool for guiding clinical decisions, specifically determining the appropriateness of outpatient management with oral antibiotics versus mandatory hospital admission for intravenous antibiotics.
Key Features and Capabilities
The "software" is typically implemented as a free, interactive calculator on various medical reference platforms (e.g., MDCalc, QxMD, EBMcalc) and mobile applications. The score is calculated based on eight clinical factors assessed at the onset of fever:
- Burden of Illness (Symptom Severity): None/mild (+5), Moderate (+3), Severe (0)
- Hypotension: Systolic blood pressure $\ge 90$ mmHg (+5), $< 90$ mmHg (0)
- Active COPD: No (+4), Yes (0)
- Type of Cancer: Solid tumor (+4), Hematologic (no prior fungal infection) (+4), Hematologic (prior fungal infection) (0)
- Dehydration Requiring IV Fluids: No (+3), Yes (0)
- Status at Onset of Fever: Outpatient (+3), Inpatient (0)
- Age: $< 60$ years (+2), $\ge 60$ years (0)
Interpretation and Use
The maximum possible score is 26. A score of $\ge 21$ points indicates a low risk for serious complications, suggesting the patient may be suitable for outpatient management with oral antibiotics. A score of $< 21$ points indicates a high risk, generally requiring hospital admission for IV antibiotics. The index has been endorsed by major societies like the Infectious Diseases Society of America (IDSA).
Target Users
The primary users are oncologists, emergency medicine physicians, infectious disease specialists, and other healthcare providers managing cancer patients with febrile neutropenia.