Welcome to the EPIPHANY calculator website! Pulmonary embolism (PE) is one of the most common and feared complications in cancer patients, given its frequency and the suffering it entails. The objective of this tool is to classify patients with cancer and pulmonary embolism (PE), whether incidental or symptomatic, according to the risk of serious complications within 15 days. Serious complications are events that lead to serious clinical deterioration or death; for example, systolic blood pressure <90 mm Hg, acute respiratory failure, right-side heart failure, acute kidney failure, major bleeding, or any other event the investigator deems serious.
This tool is intended only for some cancer patients, so we will check the eligibility criteria before you can access the calculator. The researchers of the EPIPHANY Study defined the concept of clinical severity based primarily on the eligibility criteria for outpatient management of the HESTIA trial, to make these criteria stricter and more nuanced in the cancer patient.
Remember that EPIPHANY was an observational study based on clinical practice, and as such, specific recommendations cannot be made regarding therapeutic strategies or the use of specific anticoagulants in this population, which would have to be elucidated in clinical trials. The scope of the model’s applicability must always be confirmed and attention must be paid to unusual risk factors that may be important in a minority of patients. The EPIPHANY index should not be used to select low risk patients who are eligible for outpatient care with anticoagulants, until a clinical trial can be carried out to confirm the safety of this approach. Predictions are only orientative, so decisions should be taken at the discretion of the attending physician.