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PESI (Pulmonary Embolism Severity Index) Calculator

The Pulmonary Embolism Severity Index (PESI) estimates 30-day mortality in acute pulmonary embolism from age plus ten clinical variables, sorting patients into risk classes I–V.

Quick answer

The Pulmonary Embolism Severity Index (PESI) estimates 30-day mortality after an acute pulmonary embolism. It adds the patient age in years to points for eleven variables (for example +60 for altered mental status, +30 for cancer or systolic BP under 100), then sorts the total into classes I (≀65) to V (>125).

PESI inputs

Validated formula

Total points = age in years + the following additions: male sex +10; cancer +30; heart failure +10; chronic lung disease +10; pulse β‰₯110/min +20; systolic BP <100 mmHg +30; respiratory rate β‰₯30/min +20; temperature <36 Β°C +20; altered mental status +60; arterial Oβ‚‚ saturation <90% +20.

Interpretation

  • Class I (≀65)β€” Very low risk β€” 30-day mortality 0–1.6%.
  • Class II (66–85)β€” Low risk β€” 30-day mortality 1.7–3.5%.
  • Class III (86–105)β€” Intermediate risk β€” 30-day mortality 3.2–7.1%.
  • Class IV (106–125)β€” High risk β€” 30-day mortality 4.0–11.4%.
  • Class V (>125)β€” Very high risk β€” 30-day mortality 10.0–24.5%.

How to use the PESI calculator

  1. 1Enter age. Enter the patient age in years β€” the score starts from this number.
  2. 2Tick the clinical variables. Tick male sex, cancer, heart failure, chronic lung disease, pulse 110 or more, systolic BP under 100, respiratory rate 30 or more, temperature under 36 Β°C, altered mental status, and oxygen saturation under 90%.
  3. 3Read the class. The tool totals the points and shows the PESI class (I–V) and its 30-day mortality band.

Medical disclaimer: This is general health information, not medical advice. It does not diagnose or treat any condition, and the results are estimates based on public reference formulas. Always consult a qualified doctor about your individual health. If you think you may have a medical emergency, contact your local emergency services immediately.

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Frequently asked questions

What PESI class is low risk?βŒ„

Classes I (≀65 points) and II (66–85) are low risk, with 30-day mortality under about 3.5%. Some low-risk patients may be considered for early discharge or outpatient treatment β€” a decision for the treating team.

What is the difference between PESI and simplified PESI?βŒ„

The original PESI uses age plus eleven weighted variables and gives five classes. The simplified PESI (sPESI) uses six equally-weighted criteria and a yes/no low-vs-high split, which is easier to apply at the bedside.

Does PESI confirm a pulmonary embolism?βŒ„

No. It assumes the PE is already diagnosed and estimates its short-term mortality risk to support decisions about where and how to treat.

Sources & validation

This calculator reproduces the published PESI score, validated for 30-day mortality risk class in acute pulmonary embolism.

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