What is the maximum MASCC score?

The maximum possible score is 26. A score of 21 or higher indicates low risk for serious complications, while a score below 21 indicates high risk.

Can a patient score both "no or mild symptoms" and "moderate symptoms"?

No. Burden of illness is a mutually exclusive choice. Select the level that best describes the patient's current clinical presentation.

Does a low MASCC score guarantee safe outpatient management?

The MASCC score is a risk stratification aid, not a standalone decision tool. Clinical judgment, local resources, patient reliability, and institutional protocols must also guide the decision.

What does "no previous fungal infection" mean in the scoring?

This criterion gives 4 points if the patient has either a solid tumor or no prior fungal infection. It is a single combined criterion — either condition qualifies.

Is this tool validated for all chemotherapy regimens?

The MASCC index was derived from a broad oncology population but may perform differently in specific subgroups. Consult current clinical guidelines for your patient population.

MASCC Febrile Neutropenia Risk Score

Name: MASCC Febrile Neutropenia Risk Score
Availability: InStock
Author: Nham Vu

Calculate the MASCC Risk Index score to classify febrile neutropenia in cancer patients as low risk (outpatient) or high risk (inpatient).

Patient Criteria

Select all criteria that apply to the patient at fever onset.

Burden of illness

No or mild symptoms +5 pts

Asymptomatic or minimal symptoms not affecting normal activity

Moderate symptoms +3 pts

Symptoms present but patient able to perform self-care

Severe symptoms +0 pts

Incapacitating symptoms requiring significant assistance

No hypotension +5 pts

Systolic blood pressure above 90 mmHg

No COPD +4 pts

No active chronic obstructive pulmonary disease

Solid tumor or no previous fungal infection +4 pts

Patient has a solid tumor, or has no prior invasive fungal infection

No dehydration +3 pts

No clinical signs of dehydration requiring IV fluids

Outpatient at onset +3 pts

Patient was an outpatient when fever developed

Age under 60 +2 pts

Patient is younger than 60 years

Select criteria and press Calculate Score

Quick Reference

Score 21 – 26 Low Risk — Outpatient candidate

Score < 21 High Risk — Inpatient management

Summary

Calculate the MASCC Risk Index score to classify febrile neutropenia in cancer patients as low risk (outpatient) or high risk (inpatient).

How it works

Select the burden of illness level: no or mild symptoms (5 points), or moderate symptoms (3 points).
Check whether the patient has no hypotension (systolic BP above 90 mmHg) for 5 points.
Check whether the patient has no COPD for 4 points.
Check whether the patient has a solid tumor or no previous fungal infection for 4 points.
Check whether the patient has no dehydration for 3 points.
Check whether the patient was an outpatient at fever onset for 3 points.
Check whether the patient is under 60 years of age for 2 points.
The tool sums the selected points and classifies the result: score 21 or higher is low risk; below 21 is high risk.

Use cases

Deciding whether a febrile neutropenia patient is a candidate for outpatient antibiotic therapy.
Supporting clinical triage in oncology wards and emergency departments.
Teaching medical students and residents the MASCC scoring criteria.
Quick bedside reference when electronic health record tools are unavailable.

Frequently Asked Questions

Last updated: 2026-07-24 · Reviewed by Nham Vu