EXPLODING BACTERIAMed Decision Speed Tools
ED Decision Tools

sPESI (Simplified Pulmonary Embolism Severity Index)

The PE is already confirmed — this asks whether the patient can go home on anticoagulation.

Low risk — consider outpatient management
sPESI 0 · ~1.1% 30-day mortality
Early discharge is reasonable IF oxygenation is adequate, bleeding risk is low, and follow-up is reliable
The score assesses none of those — you do
0pts
Age >80 years
Cancer (active, or within the past 6 months)
Chronic cardiopulmonary disease (heart failure or chronic lung disease)
Heart rate ≥110 bpm
Systolic BP <100 mmHg
O₂ saturation <90%
Jiménez D, et al. 2010 · Prognostic, not diagnostic — sPESI is meaningless until the PE is confirmed. sPESI 0 is a necessary but NOT sufficient condition for discharge: it does not assess bleeding risk, follow-up, or social circumstances. If SBP <90 with haemodynamic instability, skip the score — that is a high-risk PE needing emergent intervention now.