Simplified PESI Score Calculator (PE Severity)
Prognosis after confirmed pulmonary embolism with the simplified Pulmonary Embolism Severity Index — age, cancer, cardiopulmonary disease, heart rate, blood pressure, oxygen saturation — 30-day mortality and outpatient eligibility.
How it works
One point each: age > 80, cancer, chronic cardiopulmonary disease, HR ≥ 110, SBP < 100, SpO₂ < 90%; 0 = low risk, ≥ 1 = high risk
Once pulmonary embolism is confirmed, the question shifts from diagnosis to prognosis: who needs a bed and who can be treated at home? The original PESI used eleven weighted variables; the simplified PESI collapses them to six yes/no items with equal weight, and any single point moves the patient out of the low-risk group. Low-risk patients have around 1% 30-day mortality, supporting early discharge on a direct oral anticoagulant when social circumstances allow. In the ESC framework, sPESI ≥ 1 patients are further split by right-ventricular imaging and troponin into intermediate-low and intermediate-high risk, while haemodynamic instability defines high risk regardless of score.
Worked example
A 62-year-old with breast cancer, heart rate 96, blood pressure 128 and saturation 94%: one point (cancer) — not low risk, admit and assess RV function.
Frequently asked questions
What are the Hestia criteria?
A checklist of clinical and social reasons a PE patient cannot go home (instability, bleeding risk, pain needing IV opioids, no support at home, etc.). Either sPESI 0 or Hestia-negative can select outpatients.
Does a high sPESI mean thrombolysis?
No — thrombolysis is for haemodynamically unstable (high-risk) PE. sPESI identifies who needs monitoring, not who needs lytics.
Related calculators
Clinical decision tool for education and for use by trained clinicians alongside judgement — not a diagnosis and not a substitute for medical assessment. Scores validated in specific populations may not apply to every patient.