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Risk stratification for clinical severity of pulmonary embolism in patients with cancer: a narrative review and MASCC clinical guidance for daily care

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Abstract

Pulmonary embolism (PE) is a leading cause of morbidity and mortality in patients with cancer. The clinical presentation and outcomes of PE range from an acute life-threatening condition requiring intensive care to a mild symptomatic condition associated with favorable outcomes and potentially candidate for early hospital discharge. The wide clinical spectrum of PE has led to the development of risk stratification models aimed at the triage of patients in emergency care departments and optimizing the utilization of health care resources. Incidental or unsuspected PE (UPE), detected during routine staging computed tomography scans, make up a significant proportion of this cohort among the oncology population. The present narrative review is aimed at examining the currently available PE risk assessment models developed for the general population and for patients with cancer including UPE. We include general recommendations for the daily care of patients with cancer-related PE and hypothesize on the factors that would potentially favor hospitalization with early discharge or ambulatory management in this setting.

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Authors and Affiliations

  1. Radiation Oncology Department, Hospital Clinic Barcelona, Barcelona, Spain

    Diego Muñoz-Guglielmetti

  2. The Christie Hospital, University of Manchester, Wythenshawe Hospital, Manchester, UK

    Tim Cooksley

  3. Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Shin Ahn

  4. Medical Oncology Department, Hospital Universitario Macarena, Seville, Spain

    Carmen Beato

  5. Internal Medicine Department, Hospital Galdakao-Usansolo, Vizcaya, Spain

    Mario Aramberri

  6. Internal Medicine Department, MD Anderson Cancer Center, University of Texas, Houston, USA

    Carmen Escalante

  7. Medical Oncology Department, Hospital Clinic Barcelona, Barcelona, Spain

    Carme Font

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  1. Diego Muñoz-Guglielmetti
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the Multinational Association of Supportive Care in Cancer (MASCC) Hemostasis Study Group

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Muñoz-Guglielmetti, D., Cooksley, T., Ahn, S. et al. Risk stratification for clinical severity of pulmonary embolism in patients with cancer: a narrative review and MASCC clinical guidance for daily care. Support Care Cancer 30, 8527–8538 (2022). https://doi.org/10.1007/s00520-022-07131-1

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