MDCalc

POMPE-C Tool for Pulmonary Embolism Mortality

Predicts mortality for cancer patients with PE.

Do not resuscitate
New or existing desire of patient to not be resuscitated from death (verbal or written)
Respiratory distress
Obvious anxiety from dyspnea or increased work of breathing
Unilateral leg swelling
Leg or arm with new, noticeable swelling causing asymmetry
Altered mental status
New or different from baseline
Heart rate ≥100 in past 6 hours
breaths/min
%

Result:

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Advice
  • The POMPE-C tool should not be the sole basis for care; clinicians should use their judgment and a full clinical evaluation. 
  • While the tool was validated for patients with active cancer found to have an acute, symptomatic PE on imaging, it may be helpful for those with incidentally identified PEs or those with inactive cancer.

Management
  • For patients with an estimated mortality risk ≤5%:
    • Overall risk of mortality is low.
    • None of the 27 patients in the validation sample with this level of mortality risk died within 30 days, consistent with 100% sensitivity.
  • For patients with an estimated mortality risk >5%:
    • Overall risk of mortality in this group is higher.
    • In the validation sample, 50 of the 156 patients with this level of mortality risk died within 30 days, consistent with 32% specificity.
  • For patients with an estimated mortality risk >50%:
    • Overall risk of mortality was very high.
    • 10 of 13 patients with this level of mortality risk died within 30 days, consistent with 77% specificity. 
Critical Actions
  • Regardless of calculated score, clinicians should consider the risks and benefits of anticoagulation and make treatment recommendations that align with patient values and preferences. 
  • Never delay resuscitative efforts for risk stratification.
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