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Printed on 4/19/2026
For informational purposes only. This is not medical advice.
The simplified Pulmonary Embolism Severity Index (sPESI) is a validated 6-variable risk tool for adults with confirmed pulmonary embolism. It classifies patients into low risk (score 0) versus higher risk (score 1 or more) for short-term mortality. It is commonly used to support decisions around outpatient management versus inpatient monitoring.
Formula: sPESI = 1 point each for: age >80, cancer history, chronic cardiopulmonary disease, HR ≥110, SBP <100, SpO2 <90.
sPESI was derived and validated by Jiménez et al. (2010) as a simplified prognostic model for pulmonary embolism outcomes.
An sPESI score of 0 identifies a lower-risk group with relatively low 30-day mortality. A score of 1 or more identifies higher-risk patients who generally require inpatient management and closer surveillance.
sPESI supports prognosis and disposition planning, but it does not replace full PE severity assessment, clinician judgment, or evaluation for right-heart strain.
Use sPESI in adults with confirmed acute pulmonary embolism to support early risk stratification and disposition decisions (outpatient pathway versus inpatient monitoring).
It is particularly useful after diagnostic confirmation when planning level of care and discussing short-term prognosis.
sPESI is a binary simplification and can miss nuances captured by broader assessments such as RV dysfunction, biomarkers, clot burden, and dynamic hemodynamics.
A low sPESI score does not by itself guarantee safe outpatient treatment; apply local PE pathway criteria, contraindications to anticoagulation, bleeding risk, and follow-up reliability.
For related assessments, see Wells Score (PE), PERC Rule and Shock Index.
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 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.
EmergencyCalculate qSOFA bedside sepsis risk score. A score of 2 or more (altered mentation, RR ≥22, SBP ≤100) flags high-risk infection requiring urgent evaluation.