In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 5 ( 2023-5-9), p. e0266305-
Abstract:
There is currently no validated score capable of classifying cancer-associated pulmonary embolism (PE) in its full spectrum of severity. This study has validated the EPIPHANY Index, a new tool to predict serious complications in cancer patients with suspected or unsuspected PE. Method The PERSEO Study prospectively recruited individuals with PE and active cancer or receiving antineoplastic therapy from 22 Spanish hospitals. The estimation of the relative frequency θ of complications based on the EPIPHANY Index categories was made using the Bayesian alternative for the binomial test. Results A total of 900 patients, who were diagnosed with PE between October 2017 and January 2020, were enrolled. The rate of serious complications at 15 days was 11.8%, 95% highest density interval [HDI], 9.8–14.1%. Of the EPIPHANY low-risk patients, 2.4% (95% HDI, 0.8–4.6%) had serious complications, as did 5.5% (95% HDI, 2.9–8.7%) of the moderate-risk participants and 21.0% (95% HDI, 17.0–24.0%) of those with high-risk episodes. The EPIPHANY Index was associated with overall survival (OS) in patients with different risk levels: median OS was 16.5, 14.4, and 4.4 months for those at low, intermediate, and high risk, respectively. Both the EPIPHANY Index and the Hestia criteria exhibited greater negative predictive value and a lower negative likelihood ratio than the remaining models. The incidence of bleeding at 6 months was 6.2% (95% HDI, 2.9–9.5%) in low/moderate-risk vs 12.7% (95% HDI, 10.1–15.4%) in high-risk (p-value = 0.037) episodes. Of the outpatients, serious complications at 15 days were recorded in 2.1% (95% HDI, 0.7–4.0%) of the cases with EPIPHANY low/intermediate-risk vs 5.3% (95% HDI, 1.7–11.8%) in high-risk cases. Conclusion We have validated the EPIPHANY Index in patients with incidental or symptomatic cancer-related PE. This model can contribute to standardize decision-making in a scenario lacking quality evidence.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0266305
DOI:
10.1371/journal.pone.0266305.g001
DOI:
10.1371/journal.pone.0266305.g002
DOI:
10.1371/journal.pone.0266305.g003
DOI:
10.1371/journal.pone.0266305.t001
DOI:
10.1371/journal.pone.0266305.t002
DOI:
10.1371/journal.pone.0266305.t003
DOI:
10.1371/journal.pone.0266305.s001
DOI:
10.1371/journal.pone.0266305.s002
DOI:
10.1371/journal.pone.0266305.s003
DOI:
10.1371/journal.pone.0266305.s004
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10.1371/journal.pone.0266305.s005
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10.1371/journal.pone.0266305.s006
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10.1371/journal.pone.0266305.s007
DOI:
10.1371/journal.pone.0266305.s008
DOI:
10.1371/journal.pone.0266305.s009
DOI:
10.1371/journal.pone.0266305.s010
DOI:
10.1371/journal.pone.0266305.s011
DOI:
10.1371/journal.pone.0266305.s012
DOI:
10.1371/journal.pone.0266305.s013
DOI:
10.1371/journal.pone.0266305.s014
DOI:
10.1371/journal.pone.0266305.s015
DOI:
10.1371/journal.pone.0266305.r001
DOI:
10.1371/journal.pone.0266305.r002
DOI:
10.1371/journal.pone.0266305.r003
DOI:
10.1371/journal.pone.0266305.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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