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    Patent Pending

    Simplified PESI (Pulmonary Embolism Severity Index)

    Predicts 30-day outcome of patients with PE, with fewer criteria than the original PESI.
    When to Use
    Pearls/Pitfalls
    Why Use

    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.

    ≤80
    0
    >80
    +1
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    <110
    0
    ≥110
    +1
    ≥100
    0
    <100
    +1
    ≥90%
    0
    <90%
    +1

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. David Jiménez

    About the Creator

    David Jiménez, MD, is associate professor at the University of Alcalá de Henares, Madrid and chief of the Venous Thromboembolism Program at the Ramón y Cajal Hospital in Madrid. He is also president-elect of the Vascular Sections of both the Spanish Society of Respiratory Medicine (SEPAR) and the Madrid Society of Respiratory Medicine (NEUMOMADRID). Dr. Jiménez's research interests include venous thromboembolism, pleural diseases and malignant mesothelioma.

    To view Dr. David Jiménez's publications, visit PubMed

    Are you Dr. David Jiménez? 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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