Bedside Rounds

Simplified PESI (sPESI) for pulmonary embolism

The simplified Pulmonary Embolism Severity Index predicts 30-day mortality after a confirmed PE and identifies low-risk patients who may be treated at home.

What goes into the sPESI

  • Age > 80 (+1)
  • Cancer (+1)
  • Chronic heart failure or chronic lung disease (+1)
  • Heart rate ≥ 110 (+1)
  • SBP < 100 mmHg (+1)
  • SpO₂ < 90% (+1)

How to interpret the result

  • 0: low risk (30-day mortality about 1%); consider early discharge if nothing else argues against it
  • ≥ 1: not low risk (about 10.9%); admit and assess RV function and troponin

Clinical pearls

  • Use only after PE is confirmed; it does not diagnose PE.
  • Combine with RV imaging and troponin to separate intermediate-low from intermediate-high risk.

Evidence

  1. Jiménez D, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170:1383-1389.

Related workups

Pulmonary embolism

Related calculators

Wells score for PEHAS-BLEDAll calculators

For education only. Check the inputs and the population the score was validated in before acting on it. Not a substitute for clinical judgment.