Pulmonary embolism severity index

Pulmonary embolism severity index

Simplified pulmonary embolism severity index (sPESI)

In simplified pulmonary embolism severity index, one point each is given for age above eighty years, cancer, chronic heart failure / pulmonary disease, pulse rate of 110 per minute or more, systolic blood pressure of less than 100 mm Hg and arterial oxyhemoglobin saturation of less than 90%. If there are no points, the 30 day mortality risk is 1.0% while if the score is one or more points, the risk is 10.9% [1].

Original pulmonary embolism severity index (PESI)

The original PESI score was more complex with 10 points each for male sex, chronic heart failure and pulmonary disease, which is added on to the age of the person. Cancer would add another 30 points and so would systolic blood pressure of less than 100 mm Hg. Pulse rate of 110/min or more, respiratory rate of more than 30/min and temperature of less than 36 degrees centigrade would add 20 points each. Altered mental status would add 60 points. If the total points calculated was 65 or lower (e.g. a female less than 65 years without any of the risk factors) it came under PESI class I with a very low 30 day mortality risk of 0-1.6%. Class II would be with 66-85 points and a low mortality risk of 1.7-3.5%, Class III with 86-105 points had moderate mortality risk of 3.2-7.1%. Class IV with 106-125 points had high mortality risk of 4-11.4% and Class V with more than 125 points had a very high mortality risk of 10-24.5% [2].

References

  1. Jimenez D, Aujesky D, Moores L, Gomez V, Lobo JL, Uresandi F, Otero R,Monreal M, Muriel A, Yusen RD. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010;170(15):1383 –1389.
  2. Aujesky D, Obrosky DS, Stone RA, Auble TE, Perrier A, Cornuz J, Roy PM, Fine MJ. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005;172(8):1041 –1046.