How can the Simplified Pulmonary Embolism Severity Index (sPESI) be used to manage patients presenting with a pulmonary embolism?

The Bottom Line:  The Pulmonary Embolism Severity Index is a validated tool for predicting 30-day mortality in patients presenting at the hospital with PE.  The Simplified PESI (sPESI) predicts 30-day mortality with accuracy similar to the PESI And can assist in deciding whether inpatient treatment is required or if the patient can safely be treated at home.

SummaryJiménez D, et al.  Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism.  Arch Intern Med. 2010 Aug 9;170(15):1383-9. doi: 10.1001/archinternmed.2010.199.
The simplified PESI predicts 30-day mortality risk with accuracy similar to PESI.  Investigators condensed the 11 PESI criteria to 7, each worth 1 point:  aged > 80 years old, history of cancer, history of chronic lung disease or heart failure (2 factors combined), pulse ≥ 110 beats per minute, systolic blood pressure (SBP) < 100 mm Hg, arterial oxygen saturation < 90%.    A score = 0 is low-risk and a score ≥ 1 is high-risk.

For information on the original PESI:
Aujesky D, et al.  Derivation and validation of a prognostic model for pulmonary embolism.  Am J Respir Crit Care Med. 2005 Oct 15;172(8):1041-6. Epub 2005 Jul 14.
Investigators applied point values for 11 factors to categorize 30-day mortality rate for 10,354 patients in the derivation cohort.   Rates of 30-day mortality based on total score, ranged from Class I (very low risk) to Class V (very high risk).  View the 11 factors with the DynaMed PESI Calculator (From the Calculators menu, select Clinical Criteria.)

For complete summary and to see results from validation cohort studies, see Clinical Prediction of Pulmonary Embolism in DynaMed.

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About Amy

Clinical Informationist at EUH Branch Library
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