Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team

Article Figures & Data

Download figure
Open in new tab
Figure 1A.
Algorithm for risk assessment and treatment of acute PE*

Table 1.

Original and Simplified Pulmonary Embolism Severity Indices

Parameter	PESI	Simplified PESI
Age	Age in years	1 point if age > 80 years
Male sex	+10 points	—
Cancer	+30 points	1 point
Chronic heart failure	+10 points	1 point
Chronic pulmonary disease	+10 points
Pulse rate ≥110 BPM	+10 points	1 point
Systolic blood pressure < 100 mm Hg	+30 points	1 point
Respiratory rate > 30 breaths per minute	+20 points	—
Temperature < 36° C	+20 points	—
Altered mental status	+60 points	—
Arterial oxyhemoglobin saturation 90%	+60 points	1 point
	Estimated 30-day Mortality
Adapted from Konstantinides SV, Meyer G, et al, 2019.	Class I, ≤ 65 points: • Very low risk: 0-1.6% Class II, 66-85 points: • Low risk: 1.7-3.5% Class III, 86-105 points • Moderate risk: 3.2-7.1% Class IV: 106-125 points: • High risk: 4.0-11.4% Class V: >125 points • Very high risk: 10.0-24.5%	0 points: 1.0% ≥1 point(s): 10.9%

Table 2.

Absolute and Relative Contraindications for Administration of Thrombolytic Therapy (Systemic and Local)^*

Absolute Contraindications	Relative Contraindications
▪ Structural intracranial disease ▪ Previous intracranial hemorrhage ▪ Ischemic stroke within 3 months (unless occurring in the prior 3 hours) ▪ Recent head trauma with fracture or brain injury ▪ Recent brain or spinal surgery ▪ Active bleeding (excluding menses) ▪ Bleeding diathesis	▪ Systolic BP > 180 ▪ Diastolic BP > 110 ▪ Recent bleeding (non-intracranial, excluding menses) ▪ Recent surgery ▪ Recent invasive procedure ▪ Chronically Anticoagulated ▪ Traumatic cardiopulmonary resuscitation ▪ Pericarditis or pericardial fluid ▪ Diabetic retinopathy ▪ Pregnancy ▪ Age >75 y ▪ Low body weight (e.g. < 60 kg) ▪ Female ▪ Black race