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Printed on 4/19/2026
For informational purposes only. This is not medical advice.
The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score for adults with confirmed acute PE. It combines demographics, comorbidities, and physiologic findings to stratify short-term mortality risk into five classes. PESI supports disposition planning and intensity-of-care decisions after PE diagnosis.
Formula: PESI = age + male sex(10) + cancer(30) + heart failure(10) + chronic lung disease(10) + pulse≥110(20) + SBP<100(30) + RR≥30(20) + temp<36(20) + altered mental status(60) + SpO2<90(20).
PESI was developed by Aujesky et al. and has been externally validated for 30-day mortality risk stratification in acute PE.
PESI classifies confirmed PE into five mortality-risk classes. Class I-II generally represent lower short-term risk, Class III intermediate risk, and Class IV-V higher risk. As class increases, closer monitoring and higher-intensity inpatient care become more likely.
PESI supports prognosis and disposition planning, but should be integrated with RV assessment, biomarkers, bleeding risk, and clinician judgment.
Use PESI in adults with confirmed acute pulmonary embolism to estimate 30-day mortality risk and guide level-of-care planning.
It is especially useful when deciding between outpatient pathway eligibility and standard inpatient management.
PESI estimates mortality risk but does not directly determine treatment strategy by itself. Some clinically important factors (for example clot burden, RV strain details, and evolving instability) are not captured in the score.
A low-risk class does not guarantee safe outpatient care; local pathway criteria, anticoagulation suitability, social support, and follow-up access remain essential.
For related assessments, see sPESI Score, Wells Score (PE) and PERC Rule.
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 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.
EmergencyCalculate the Shock Index (HR/SBP ratio) for rapid hemodynamic assessment. Normal: 0.5–0.7. Score ≥1.0 indicates hemodynamic compromise; ≥1.4 indicates severe shock requiring immediate intervention.