Pulmonary Embolism Severity Index (PESI)
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Indications
- predicts 30-day outcome of patients with pulmonary embolism
Procedure
- 11 clinical criteria
- age
- gender (male > female)
- history of cancer
- history of heart failure
- history of chronic lung disease
- heart rate >= 110/min
- systolic BP < 100 mm Hg
- respiratory rate > 30/min
- temperature < 36 C
- altered mental status (disorientation, lethargy, stupor, or coma)
- simplified clinical criteria[1]
- age
- cancer
- chronic cardiopulmonary disease
- heart rate
- systolic blood pressure
- SaO2
Interpretation
- a score using 11 clinical criteria
- < 65 low risk*
- 85-105 intermediate risk
- 106-125 high risk
- > 125 very high risk
* low risk simply defined[3]
- <= 80 years without significant comorbidity
- pulse rate < 110/min
- systolic blood pressure >= 100 mm Hg
- oxygen saturation >= 90%
Management
- low risk patients can be treated as outpatients[3]
- direct oral anticoagilants (apixaban, rivaroxaban) for most patients
Notes
- all factors positive
- altered mental status, history of cancer & systolic BP < 100 mm Hg strongest predictors
More general terms
References
- ↑ 1.0 1.1 Jimenez D, Aujesky D, Moores L et al Simplification of the Pulmonary Embolism Severity Index for Prognostication in Patients With Acute Symptomatic Pulmonary Embolism. Arch Intern Med. 2010;170(15):1383-1389 PMID: https://pubmed.ncbi.nlm.nih.gov/20696966 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/775646
- ↑ Aujesky D Pulmonary Embolism Severity Index (PESI) https://www.mdcalc.com/pulmonary-embolism-severity-index-pesi
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025