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Simplified PESI
Risk stratify confirmed PE patients to identify those safe for outpatient treatment. A score of 0 identifies low-risk patients.
Indication
- Risk stratify confirmed PE patients to identify those safe for outpatient treatment. A score of 0 identifies low-risk patients.
Criteria
- id: age80; label: Age >80 years; type: yesno; points: 1
- id: cancer; label: Active cancer; type: yesno; points: 1
- id: cardiopulm; label: Chronic cardiopulmonary disease (CHF or COPD); type: yesno; points: 1
- id: hr110; label: Heart rate ≥110 bpm; type: yesno; points: 1
- id: sbp100; label: Systolic BP <100 mmHg; type: yesno; points: 1
- id: spo2; label: Oxygen saturation <90%; type: yesno; points: 1
Interpretation
- function(score) { if (score === 0) return { risk: score + ' pts', tier: 'Low Risk', action: '30-day mortality ~1.0%. Consider outpatient treatment with LMWH or DOAC \u2014 Hestia criteria must also all be NO.', color: 'green' }; return { risk: score + ' pts', tier: 'Not Low Risk', action: '30-day mortality ~10.9%. Hospitalization recommended. Assess for RV dysfunction and troponin.', color: 'red' }; }
Clinical pearls
- sPESI of 0 has NPV >99% for 30-day mortality when combined with Hestia criteria
- Approximately 25–30% of PE patients are low-risk and candidates for outpatient treatment
- RV dysfunction on echo/CT, elevated troponin, or elevated BNP upgrade risk regardless of sPESI
- The original (non-simplified) PESI uses 11 weighted variables for five risk classes
Source and review
- Jimenez D et al. Arch Intern Med 2010. Last reviewed: 2025-01-01