Loading...
Printed on 4/19/2026
For informational purposes only. This is not medical advice.
The HESTIA approach is a practical bedside checklist used after confirmed pulmonary embolism to identify patients who should not be managed as outpatients. If no exclusion criteria are present, outpatient treatment may be considered in suitable systems with close follow-up.
Formula: HESTIA is a checklist: outpatient eligibility typically requires zero exclusion criteria.
The HESTIA strategy has been prospectively studied to support selection of low-risk PE patients for outpatient treatment.
If one or more HESTIA criteria are present, inpatient treatment is generally favored due to higher short-term risk or care complexity. If none are present, outpatient treatment may be considered in clinically stable patients with reliable follow-up.
HESTIA is a safety-oriented disposition screen, not a mortality score.
Use HESTIA after confirming pulmonary embolism when deciding outpatient versus inpatient treatment pathways.
It is especially useful in ED pathways that include early discharge protocols for selected low-risk PE patients.
HESTIA is a checklist and does not provide graded mortality risk. It should be integrated with prognostic tools, imaging/biomarker findings, and local resources.
Thresholds and definitions can vary slightly by institution, so align use with your local PE pathway.
For related assessments, see PESI Score, sPESI Score and Wells Score (PE).
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
Calculate full PESI to classify 30-day mortality risk in confirmed pulmonary embolism (Class I-V).
EmergencyCalculate sPESI to estimate 30-day mortality risk in confirmed pulmonary embolism and support disposition decisions.
EmergencyCalculate Wells Score for PE to estimate pretest probability and guide D-dimer testing versus direct CTPA for pulmonary embolism workup.
EmergencyUse PERC (Pulmonary Embolism Rule-out Criteria) to rule out PE in low-risk patients without D-dimer or CT when all 8 criteria are negative.