sPESI | simplified Pulmonary Embolism Severity Index
Estimate risk of 30-day mortality in patients with acute PE
The simplified Pulmonary Embolism Severity Index (sPESI) is a tool to risk stratify patients into “Low” or “High” risk groups of mortality based on clinical parameters in the context of a new acute pulmonary embolism (PE). As highlighted in the name, this tool simplifies the validated PESI score into binary answer options to increase clinical utility and help determine who is safe to be discharged for outpatient management.
The PESI score was derived and validated to assist in disposition planning for patients with acute PE. The study group successfully showed that patients with no high-risk clinical features in the absence of social issues could safely be discharged home due to demonstrated low rates of 30-day mortality in that population. The simplified PESI was created because study authors noted that the 11-variable weighted PESI score was impractical to calculate for many ED providers which limited its uptake.
The sPESI offered the same prognostic accuracy as the PESI score in both the derivation and retrospective external validation cohort. Patients classified as low-risk in the validation had a 30-day mortality of 1.1% (95% CI, 0.7%-1.5%) compared with 8.9% (8.1%-9.8%) in the high-risk group. The authors conclude that the sPESI is a practical tool to help identify low-risk patients that could be discharged early or managed entirely in the outpatient setting.
Variable & Associated Points
- Age > 80 years old (Yes +1, No 0)
- History of cancer (Yes +1, No 0)
- History of chronic cardiopulmonary disease (Yes +1, No 0)
- Heart rate ≥ 110 beats per minute (Yes +1, No 0)
- Systolic Blood Pressure < 100 mmHg (Yes +1, No 0)
- Oxygen saturation < 90% (Yes +1, No 0)
Jimenez D, Aujesky D, Moores L, et al.