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Table 2 Risk assessment models developed for cancer-related pulmonary embolism

From: Emergency management of incidental pulmonary embolism (IPE)

POMPE-C [38] RIETE [36] EPIPHANY Index [40, 41] Workup scenarios (4S rule) [39]
Patient weight Metastatic disease + 4 Clinical decision rule** Presence ≥ 1 vs. none   TA-UPE SPE UPE-S
Respiratory rate (breath/min)* Immobilisation + 2 ECOG performance status scale ≥ 2 vs. < 2 Setting at PE diagnosis Outpatient In/outpatient In/outpatient
Oxygen saturation$ Age > 80 years + 1 PE-specific symptoms Yes/no PE suspicion No Yes No
Heart rate > 100 bpm Heart rate ≥ 110 bpm + 1 Pulse oximetry SaO2 < 90% vs. ≥ 90% Vital signs Normal Any Any
Altered mental status& Systolic BP < 100 mmHg + 1 Tumour response assessment***   Symptoms No Yes Yes
Respiratory distressΦ Body weight < 60 kg + 1 Surgery of the primary tumour Yes/no  
Do not resuscitate status¢    
Unilateral limb swelling    
Risk stratification Risk class 30-day mortality Tree modelling risk score° 15-day serious complications Mortality 30-day mortality
30-day death probability according to math calculation Class 1: low-risk < 2 0–4% Low-risk 1.6% 0.3%   TA-UPE SPE UPE-S
Class 2: intermediate-risk 2–4   Intermediate-risk 9.4% 6.1%   3% 21% 20%
Class 3: high-risk 5–7   High-risk 30.6% 17.1%    
Class 4: Very high-risk > 7 20–30%   No difference in MB or recurrence of VTE within 90 days of follow-up
  1. BP blood pressure, bpm beats per minute, MB major bleeding, PE pulmonary embolism, VTE venous thromboembolism, TA-UPE truly asymptomatic and unsuspected PE, SPE suspected PE, UPE-S unsuspected PE with symptoms
  2. *Highest documented respiratory rate within previous 6 h
  3. $Most recent pulse oximetry measured in room air
  4. &Acute impairment in consciousness, new disorientation, delirium or confusion
  5. ΦDyspnea or increased work for breathing
  6. ¢Written or verbal desire of the patient not to be resuscitated
  7. **Adaptation of Hestia’s exclusion criteria
  8. ***Progressive disease, unknown/not evaluated disease, complete or partial response, stable or no evidence of disease
  9. °Within 15 days from PE