🧫 CISNE (Stable Febrile Neutropenia Risk)
The CISNE score stratifies complication risk in clinically stable solid-tumor patients with febrile neutropenia.
CISNE (Stable Febrile Neutropenia Risk)
ECOG performance status ≥2
Stress hyperglycemia
Chronic obstructive pulmonary disease
Chronic cardiovascular disease
Mucositis grade ≥2 (NCI)
Monocytes <200/μL
When to use
Select the six clinical features; the tool sums weighted points (0–8) and assigns low, intermediate, or high risk.
How it works
CISNE = 2×(ECOG ≥2) + 2×(stress hyperglycemia) + COPD + cardiovascular disease + mucositis ≥grade 2 + monocytes <200/μL. 0 low, 1–2 intermediate, ≥3 high.
Key points
- CISNE applies only to patients who already appear stable, with no organ failure, shock, or severe infection (original synthesis · not guideline verbatim).
- Low-risk patients may be candidates for outpatient oral antibiotics, whereas ≥3 points warrants admission.
- CISNE is more specific than MASCC in the emergency department, reducing misclassification of stable patients as low-risk.
References
- Carmona-Bayonas A, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia (CISNE). J Clin Oncol. 2015.
- Coyne CJ, et al. Application of the CISNE score in the emergency department. Ann Emerg Med. 2017.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.