The Pulmonary Embolism Severity Index (PESI) can help to identify a patient with significant short-term mortality following a pulmonary embolism. A patient at greater risk may benefit from more aggressive management. The authors are from the University of Lausanne, the University of Geneva, University of Pittsburgh, VA Pittsburgh Healthcare System and the University of Angers.
Patient selection: adults (age >= 18 years) with pulmonary embolism
Parameters:
(1) age in years
(2) gender
(3) cancer
(4) heart failure
(5) chronic lung disease
(6) heart rate
(7) systolic blood pressure
(8) respiratory rate
(9) body temperature
(10) mental status
(11) arterial oxygen saturation
|
Parameter |
Finding |
Points |
|---|---|---|
|
age |
number of years |
(years) |
|
gender |
female |
0 |
|
|
male |
10 |
|
cancer |
absent |
0 |
|
|
present |
30 |
|
heart failure |
absent |
0 |
|
|
present |
10 |
|
chronic lung disease |
absent |
0 |
|
|
present |
10 |
|
heart rate |
< 110 beats per minute |
0 |
|
|
>= 110 beats per minute |
20 |
|
systolic blood pressure |
>= 100 mm Hg |
0 |
|
|
< 100 mm Hg (hypotension) |
30 |
|
respiratory rate |
< 30 breaths per minute |
0 |
|
|
>= 30 breaths per minute |
20 |
|
temperature |
>= 36°C |
0 |
|
|
< 36°C |
20 |
|
mental status |
normal |
0 |
|
|
altered (disorientation, lethargy, stupor, coma) |
60 |
|
arterial oxygen saturation |
>= 90% |
0 |
|
|
< 90% |
20 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 18 (depends on the patient's age)
• maximum score: over 330 (depends on the patient's age)
• The higher the score the greater the 30-day mortality after a pulmonary embolism.
|
Total Score |
Risk Class |
Risk Description |
|---|---|---|
|
< 65 |
I |
very low |
|
65 to 85 |
II |
low |
|
86 to 105 |
III |
intermediate |
|
106 to 125 |
IV |
high |
|
> 125 |
V |
very high |
Purpose: To evaluate an adult with a pulmonary embolism using the Pulmonary Embolism Severity Index (PESI) of Aujesky et al.
Specialty: Pulmonology
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: C00-C14, C15-C26, C30-C39, C40-C41, C43-C44, C45-C49, C50-C50, C51-C58, C60-C63, C64-C68, C69-C72, C73-C75, C76-C80, C81-C96, C97-C97, I20-I25, I26, J40-J47,
