POMPE C Score for Pulmonary Embolism Mortality Calculator

How does this POMPE-C score for pulmonary embolism mortality calculator work?

This is a health tool based on the POMPE-C scoring which is a mortality prediction for patients with pulmonary embolism which is often used for patients that also suffer from cancer.

There are two types of predictor variables, five dichotomies (see from 1 to 5 below) and three continuous (see from 6 to 8). For the first five, the answer will be either yes or no, in the positive case the value 1 is awarded while in the case of the negative answer, the value zero is given. For the remaining three values, the value input in the Pompe-C score for pulmonary embolism mortality calculator will be used in the scoring result.

1. Do not resuscitate [DNR] – existing verbal or written consent from the patient to not resuscitate;

2. Altered mental status [AMS];

3. Respiratory distress [RespD] – presence of dyspnea or increased breathing work;

4. Unilateral leg swelling [ULS] – observing asymmetry possibly due to DVT;

5. Heart rate higher than 100 bpm [HR] – increased heart rate in the past six hours;

6. Highest respiratory rate in past six hours [RR]– place to input value;

7. O2 saturation [O₂sat]– in room air, place to input percent;

8. Weight [W] – place to input weight in either lbs or kg.

POMPE-C formula = 100 * (1 - 1 / (1 + Exp(3.718 + DNR*1.55171 + RespD*0.79961 + ULS*0.73433 + AMS*1.47345 + HR*1.02789 + (RR*0.04422) + (O₂sat*(-0.063)) + (W in lbs *( -0.01161)))))

POMPE-C results predict mortality for the following 30 days after the episode and the percentage given can be taken as evidence as there is no other risk category involved in particular such as in other scores.

A result equal or lower than 5% can be considered as low risk and should be considered for anticoagulation therapy and even be treated outpatient. Higher scores have intermediate to high risk (greater than 50%) and usually require ICU care.

POMPE-C score and cancer

There seems to be a better correlation between the POMPE-C scoring system and statistical evidence in cases of cancer patient than in other pulmonary embolism mortality scores such as PESI.

Despite the great statistical results and the accurate risk stratification, this model shouldn’t trump clinical judgment and additional pathologies or comorbidities should be taken in consideration even in cases that present a low POMPE-C score.

Reference

Kline JA, Roy PM, Than MP, Hernandez J, Courtney DM, Jones AE, Penaloza A, Pollack CV Jr. Derivation and validation of a multivariate model to predict mortality from pulmonary embolism with cancer: The POMPE-C tool. Thromb Res. 2012 May;129(5):e194-9. doi: 10.1016/j.thromres.2012.03.015. Epub 2012 Apr 3.