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Simplified Pulmonary Embolism Severity Index (sPESI)

sPESI scores 1 point each for age >80, cancer, chronic cardiopulmonary disease, HR ≥110, SBP <100 and SaO₂ <90%. A score of 0 is low risk (30-day mortality ~1.0%); ≥1 is high risk (~10.9%).

Age (years)
Active cancer (yes/no, +1)
Chronic cardiopulmonary disease (heart failure or chronic lung disease) (yes/no, +1)
Heart rate (/min)
Systolic blood pressure (mmHg or kPa)
Arterial oxygen saturation (SaO₂) (%)

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Interpretation

Result	Meaning
0	Low risk (1.0% 30-day mortality)
≥ 1	High risk (10.9%)

Formula

One point each: age > 80 · cancer · chronic cardiopulmonary disease · HR ≥ 110 · SBP < 100 · SaO₂ < 90%

Clinical pearls

sPESI 0 plus no RV dysfunction is the ESC "low-risk" group eligible for early discharge.
sPESI ≥1 with RV dysfunction and raised troponin defines intermediate-high risk, warranting monitoring for decompensation.

Examples

spesi 84F hr 95 sbp 130 sat 94 simplified pesi for a 60 year old with copd, pulse 115, BP 105/70, sats 92%spesi 45M hr 80 bp 120 sat 98 no comorbidities

FAQ

What does an sPESI of 0 mean?

Low risk, with about 1% 30-day mortality in the derivation cohort; such patients may be candidates for early discharge.

Is sPESI as good as PESI?

It has similar prognostic accuracy and is easier to calculate.

Evidence

Jiménez D et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med 2010;170:1383–9.

Cardiology · Reviewed 2026-10-14 · Methodology