Pulmonary Embolism Severity Index (PESI)
What is the 30-day mortality risk of a patient with confirmed acute PE?
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About this tool
Eleven-variable score that classifies patients with acute PE into five risk classes for 30-day mortality.
Intended use
Adults with objectively confirmed acute PE, to inform site of care.
Outcome
All-cause mortality
Time horizon
30 days
Derivation population
Patients with acute PE in Pennsylvania hospitals (derivation) with internal/external validation.
Limitations
- Age contributes heavily, so older patients rarely score low risk.
- Does not include RV dysfunction or biomarkers.
Clinical problems
Evidence
Evidence level
Strong evidence
Derived and externally validated in multiple cohorts (including prospective studies) and incorporated into major clinical guidelines. Methodology
Guideline status
Used for risk stratification in the 2019 ESC acute PE guideline.
References
- Original publicationAujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005;172:1041-1046. Find on PubMed (opens in a new tab)
Version history
| Version | Formula | Effective | Reviewer | Changes |
|---|---|---|---|---|
| v1.0.0 | Aujesky 2005 | 2026-10-03 | — | Initial implementation with reference test vectors. |
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Clinical decision support only. Interpret results in the context of the individual patient and current guidance; HumanPulse does not replace professional medical judgment.