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    Pulmonary Embolism Severity Index (PESI)

    Predicts 30-day outcome of patients with pulmonary embolism using 11 clinical criteria.
    When to Use
    Pearls/Pitfalls
    Why Use

    In the setting of a patient diagnosed with PE, the PESI can be utilized to determine mortality and long term morbidity. For those determined to be very low risk (score ≤ 65), all studies showed a 30-day mortality <2%. In the validation, low risk (Class I and II) had a 90-day mortality of 1.1%. The non-inferiority trial demonstrated Class I and II could have been treated as outpatients assuming no other issues.

    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 PESI is designed to risk stratify patients who have been diagnosed with a PE in order to determine the severity of their disease. This can help physicians make decisions on the management of those patients who could potentially be treated as out-patient, as well as raise concern for those who are determined to be high-risk and could benefit from higher levels of care.

    years
    Female
    0
    Male
    +10
    No
    0
    Yes
    +30
    No
    0
    Yes
    +10
    No
    0
    Yes
    +10
    No
    0
    Yes
    +20
    No
    0
    Yes
    +30
    No
    0
    Yes
    +20
    No
    0
    Yes
    +20
    No
    0
    Yes
    +60
    No
    0
    Yes
    +20

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    Next Steps
    Evidence
    Creator Insights
    Dr. Drahomir Aujesky

    About the Creator

    Drahomir Aujesky, MD, MS, is an active clinician-investigator who predominantly researches venous thromboembolism. He was previously a full-time clinician at the University of Lausanne in Switzerland and completed the intensive Clinical Research Training Program (CRTP) under the direction of Dr. Michael Fine at the University of Pittsburgh.

    To view Dr. Drahomir Aujesky's publications, visit PubMed

    Are you Dr. Drahomir Aujesky? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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