Criterion | PESI | sPESI |
---|---|---|
Age | 1 per year of age | >80 years of age = 1 |
Male sex | 10 | |
Malignancy | 30 | 1 |
Heart failure | 10 | 1 |
Lung disease | 10 | |
Heart rate ≥ 110/min | 20 | 1 |
Systolic blood pressure < 100 mmHg | 30 | 1 |
Respiratory rate ≥ 30/min | 20 | |
Body temperature < 36°C | 20 | |
Lowered level of consciousness, confusion | 60 | |
Oxygen saturation < 90% with indoor air | 20 | 1 |
Interpretation | ||
PESI score | Class | 30-day risk of death |
<65 points | I: Very low risk | 0-1.6 % |
66-85 points | II: Low risk | 1.7-3.5 % |
86-105 points | III: Moderate risk | 3.2-7.5 % |
106-125 points | IV: High risk | 4.0-11.4 % |
>125 points | V: Very high risk | 10.0-24.5 % |
sPESI score | ||
0 points | Low mortality risk | 1.1 % |
≥point or more | High mortality risk | 8.9 % |
Lähteet:
1 Aujesky D, Obrosky DS, Stone RA ym. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005;172(8):1041-6. [PubMed]
2 Jiménez D, Aujesky D, Moores L ym. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010;170(15):1383-9. [PubMed]
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Predisposing factors
Symptoms and findings
Clinical assessmentAssessment of pretest probability
A clinical model for the assessment of the probability of pulmonary embolism
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Source: Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorize patients' probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 2000;83:416-420 [PubMed] | ||||||||||||||||||||||||
Investigation and treatment strategy in suspected PE D-Dimer Testing and Pulmonary Embolism
Diagnosing PE Safety of Ruling out Acute Pulmonary Embolism in Outpatients by Normal Computed Tomography Pulmonary AngiographyCT angiography of the pulmonary arteries
Ultrasonography of the legs
Perfusion scan (nuclear scan)
Laboratory testsArterial blood gas analysis
D-dimer D-Dimer Testing and Pulmonary Embolism
Other laboratory tests
Chest x-ray
Treatment Outpatient Treatment for Acute Pulmonary EmbolismTreatment of circulatory shock
Choice of treatment
Anticoagulant therapy Oral Direct Thrombin Inhibitors or Oral Factor Xa Inhibitors for the Treatment of Pulmonary Embolism
Thrombolytic therapy (fibrinolytic therapy) Thrombolytic Therapy in Pulmonary Embolism
Inferior vena cava filter (IVC filter) Vena Caval Filters for the Prevention of Pulmonary Embolism
Invasive or surgical management
Further treatment
References
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