Simplified PESI (Pulmonary Embolism Severity Index)

In the setting of a patient diagnosed with pulmonary embolism, the sPESI can be utilized to determine if he/she is a possible candidate for outpatient management. For those determined to be low risk (score of 0), mortality risk is 1.1%.

The Simplified Pulmonary Embolism Severity Index (sPESI) was designed to remove some of the more complicated elements of the Pulmonary Embolism Severity Index (PESI) and aid in the risk stratification of patients with pulmonary embolism (PE).

• The sPESI is easier to remember and simpler to use than its predecessor.
• The sPESI has been shown to be equally as accurate as, if not more than, the original PESI.
• The sPESI is a rule-out type of tool. ALL criteria must be answered “no” in order for the patient to be considered low-risk.
• The sPESI is meant to aid in decision making, not replace it. Clinical judgement should always take precedence.
• Patients determined to be low risk can be considered for outpatient management if clinical and social factors warrant it.

About the PESI:

The Pulmonary Embolism Severity Index (PESI) is a risk stratification tool that has been externally validated to determine the mortality and outcome of patients with newly diagnosed pulmonary embolism (PE).

In the setting of a patient with renal failure or severe comorbidities, clinical judgement should be used over the PESI, as these patients were excluded in the validation study.

• The PESI score determines risk of mortality and severity of complications.
• The score does not require laboratory variables.
• It is meant to aid in decision making, not replace it. Clinical judgement should always take precedence.
• The PESI score determines clinical severity and can influence treatment setting for management of PE.
  • Class I and II patients may possibly be safely treated as outpatients in the right clinical setting.

The sPESI is a simpler version of the PESI that is easy to apply to patients who have been diagnosed with PE. In the derivation study it had a better negative predictive value than the PESI. It is simpler to use and comparable in accuracy.