Contents

Search

Pulmonary Embolism Severity Index (PESI)

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

General

numerical rating scale (NRS)

References

  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: 20696966 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/775646
  2. Aujesky D Pulmonary Embolism Severity Index (PESI) https://www.mdcalc.com/pulmonary-embolism-severity-index-pesi
  3. Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025