PESI score for severity of PE

see also:

• ED Mx of pulmonary embolism (PE)
• HOPPE score for outpatient Mx of PE
• American Journal of Respiratory and Critical Care Medicine 2005 Derivation and Validation of a Prognostic Model for Pulmonary Embolism
• Arch Intern Med. 2006 A prediction rule to identify low-risk patients with pulmonary embolism.

• a severity score for pulmonary embolism (PE) developed in 2005 based upon 15,531 inpatient discharges with pulmonary embolism from 186 Pennsylvania hospitals and externally validated the rule in 221 inpatients with pulmonary embolism from Switzerland and France

• MDCalc PESI calculator

• stratifies PE patients into 5 severity classes with varying 30 day mortality:
  • class I score < 65: < 1.7% mortality
  • class II score 66-85: 1.7-3.5% mortality
  • class III score 86-105: 3.2-7.1% mortality
  • class IV score 106-125: 4-11.4% mortality
  • class V score > 125: 10-24.5% mortality

• Arch Intern Med. 2010 Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism.

High risk and 8.9% mortality rate if ANY of:

• age > 80yrs
• PH cancer
• PH chronic lung disease
• HR >= 110
• Systolic BP < 100mmHg
• Sa O2 < 90%

Otherwise “Low Risk” and thus:

• 1.1% mortality
• 1.5% of recurrent VTE or non-fatal bleeding

MDCalc Simplified PESI score