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respiratory oncology haematology

EPIPHANY Index for PE in Cancer

Predicts clinical outcome of pulmonary embolism (PE) in cancer patients. Guides management intensity (outpatient vs admission vs ICU) and anticoagulation decisions.

Score interpretation

High Risk — ICU or HDU

→ EPIPHANY High Risk (≥3): High mortality risk PE in cancer. ICU/HDU admission; full anticoagulation (LMWH preferred in cancer — dalteparin or DOAC if low bleeding risk per CARAVAGGIO trial); consider systemic thrombolysis if massive PE; haematology/oncology involvement.

Intermediate Risk — Admit

→ EPIPHANY Intermediate Risk (1–2): Moderate mortality risk. Hospital admission; LMWH (therapeutic dose dalteparin/tinzaparin) or DOAC (apixaban, rivaroxaban); monitor for deterioration; oncology review.

Low Risk — Consider Outpatient

→ EPIPHANY Low Risk (0): Low mortality risk. Consider outpatient management if ECOG 0–1, haemodynamically stable, and social support adequate; DOAC preferred (apixaban or rivaroxaban); oncology follow-up within 48 hours.

Interpretation bands for the EPIPHANY Index. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.