🫁 PESI Mortality Score Calculator Simulator

Confirmed PE — Why Score It At All

Scoring starts the moment imaging confirms clot.

• ~900K: PE incidence (US/yr) (estimated annual cases)
• 11: PESI variables (age + 10 clinical factors)
• Multiple: Validation cohorts (derivation + external)
• Triage: Purpose (home vs hospital decision)

Why risk-stratify PE

Not every PE needs a hospital bed. Scoring finds the safe-to-discharge group.

Placeholder: low-risk patients can often go home safely.

What PESI measures

Age plus nine clinical and vital-sign variables, summed into one score.

Original vs simplified

A simplified PESI (sPESI) also exists as a binary yes/no version.

Age Points — One Point Per Year

Age enters the score directly, unlike other variables.

• 18–95: Age range modeled (slider bounds)
• 1: Points per year (direct contribution)
• ~95 pts: Max age contribution (at oldest end)
• Fixed pts: Other variables (not scaled by severity)

Why age is linear

Age tracks mortality risk closely, so it is added as raw years.

Placeholder: older patients start with a higher baseline score.

Baseline before comorbidity

Age alone can already push a patient toward a higher class.

Interpreting the bar

The blue segment in the chart always equals patient age.

Cancer, Heart Failure, Lung Disease

Three chronic conditions each add fixed point values.

• +30: Cancer history (points if present)
• +10: Heart failure (points if present)
• +10: Chronic lung disease (points if present)
• 50: Max comorbidity total (all three present)

Cancer weighting

Active cancer carries the largest comorbidity weight, 30 points.

Placeholder: cancer history alone can shift risk class meaningfully.

Cardiopulmonary disease

Heart failure and chronic lung disease each add 10 points.

Stacking on the chart

Orange blocks stack above the age bar in the tally.

Tachycardia, Hypotension, Hypoxemia & More

Abnormal exam findings add the largest point values.

• +60: Altered mental status (highest single weight)
• +30: Systolic BP <100 (hypotension)
• +20 ea: Resp rate / O2 / HR / temp (four separate factors)
• 170: Max vital-sign total (all six present)

Mental status dominates

Altered mental status alone adds 60 points, the biggest weight.

Placeholder: vital-sign abnormalities often decide the risk class.

Hemodynamic instability

Low systolic blood pressure signals possible right heart strain.

Respiratory and thermal signs

Tachypnea, hypoxemia, tachycardia, and hypothermia each add points.

Risk Class I–V & Disposition

Total score sorts patients into five mortality classes.

• Outpatient: Class I–II (score ≤85, low mortality)
• Inpatient: Class III–V (score >85, hospitalize)
• 0–1.6%: Class I mortality (very low risk)
• 10–24.5%: Class V mortality (very high risk)

Five risk classes

Score thresholds at 65, 85, 105, 125 define classes I through V.

Placeholder: class III is the tipping point toward hospitalization.

Outpatient eligibility

Class I–II patients are candidates for safe home treatment.

Using the score responsibly

PESI supports, but does not replace, overall clinical judgment.

Risk class reference