Cost of Cancer-Related Neutropenia or Fever Hospitalizations, United States, 2012

J Oncol Pract. 2017 Jun;13(6):e552-e561. doi: 10.1200/JOP.2016.019588. Epub 2017 Apr 24.


Purpose: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations.

Methods: We examined data from the 2012 National Inpatient Sample and Kids' Inpatient Database. Hospitalizations for cancer-related neutropenia were defined as those with a primary or secondary diagnosis of cancer and a diagnosis of neutropenia or a fever of unknown origin. We examined characteristics of cancer-related neutropenia hospitalizations among children (age < 18 years) and adults (age ≥ 18 years). Adjusted predicted margins were used to estimate length of stay and cost per stay.

Results: There were 91,560 and 16,859 cancer-related neutropenia hospitalizations among adults and children, respectively. Total cost of cancer-related neutropenia hospitalizations was $2.3 billion for adults and $439 million for children. Cancer-related neutropenia hospitalizations accounted for 5.2% of all cancer-related hospitalizations and 8.3% of all cancer-related hospitalization costs. For adults, the mean length of stay for cancer-related neutropenia hospitalizations was 9.6 days, with a mean hospital cost of $24,770 per stay. For children, the mean length of stay for cancer-related neutropenia hospitalizations was 8.5 days, with a mean hospital cost of $26,000 per stay.

Conclusion: We found the costs of cancer-related neutropenia hospitalizations to be substantially high. Efforts to prevent and minimize neutropenia-related complications among patients with cancer may decrease hospitalizations and associated costs.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Child
  • Child, Preschool
  • Databases, Factual / statistics & numerical data
  • Female
  • Fever / chemically induced
  • Fever / economics*
  • Hospital Costs / statistics & numerical data*
  • Hospitalization / economics*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neutropenia / chemically induced
  • Neutropenia / economics*
  • United States
  • Young Adult


  • Antineoplastic Agents