Pulmonology Book

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Pulmonary Embolism Severity Index

Aka: Pulmonary Embolism Severity Index, PESI
  1. Indications
    1. Predicts 30 day mortality from Pulmonary Embolism
    2. Risk stratify management
      1. Thrombolytic treatment of Massive Pulmonary Embolism (class 4-5)
      2. Outpatient management for low risk Pulmonary Embolism (class 1)
  2. Criteria
    1. Score 1/y: Age
    2. Score 10: Male gender
    3. Score 30: Cancer - active or past history
    4. Score 10: Heart Failure
    5. Score 10: Chronic lung disease
    6. Score 20: Heart Rate >110 bpm
    7. Score 30: Systolic Blood Pressure <100 mmHg
    8. Score 20: Respiratory Rate >30 bpm
    9. Score 20: Temperature <36 C
    10. Score 60: Altered Mental Status
    11. Score 20: Oxygen Saturation <90%
  3. Interpretation: Mortality at 30 days
    1. Score <66: Class 1 - Very low mortality risk (0 to 1.6%)
    2. Score <86: Class 2 - Low mortality risk (1.7 to 3.5%)
    3. Score <106: Class 3 - Moderate mortality risk (3.2 to 7.1%)
    4. Score <126: Class 4 - High mortality risk (4.0 to 11.4%)
    5. Score >126: Class 5 - Very high mortality risk (10.0 to 24.5%)
  4. References
    1. Aujesky (2005) Am J Respir Crit Care Med 172(8): 1041 [PubMed]

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