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PESI Score Calculator

Enter the patient's age and clinical findings to compute the PESI score and risk class.

How it is calculated

The score starts with the age in years and adds fixed points for each finding present: male sex +10, cancer +30, heart failure +10, chronic lung disease +10, pulse ≥ 110 per minute +20, systolic blood pressure < 100 mmHg +30, respiratory rate ≥ 30 per minute +20, temperature < 36 °C +20, altered mental status +60, and oxygen saturation < 90% +20. The total sets the class: up to 65 is Class I, 66–85 II, 86–105 III, 106–125 IV and above 125 V. The mortality band is a fixed text for each class, not a calculation for the individual patient. Vital signs are compared exactly at the cut-offs shown (110 counts, 100 does not). Temperature must be in degrees Celsius. Any sex other than male adds no points, and the four yes/no findings count only when set to yes. This is an aid for clinicians and not medical advice.

Worked example

A 72-year-old woman has a pulse of 112 per minute, systolic pressure of 96 mmHg, respiratory rate 22, temperature 36.8 °C and oxygen saturation 93%, with no cancer, heart failure, lung disease or confusion. Start with age: 72. Female sex adds 0. Pulse 112 is ≥ 110: +20. Systolic 96 is under 100: +30. Respiratory rate 22, temperature 36.8 and saturation 93% add nothing. Total = 72 + 20 + 30 = 122 points, which falls in Class IV (106–125), shown with the band High (≈4.0–11.4%).

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Common mistakes

  • Entering the temperature in Fahrenheit. A value like 98.6 is never below 36, so the +20 for low temperature is silently missed. Use Celsius.
  • Leaving the sex field out and assuming no points are added. The tool defaults to male when no value is sent through the link, which adds 10 points.
  • Misreading the boundaries. A pulse of exactly 110 and a respiratory rate of exactly 30 score points, while a systolic pressure of exactly 100, temperature of exactly 36 and saturation of exactly 90 do not.
  • Using the numbers as a probability for one patient. The mortality text belongs to the whole class and bands for neighbouring classes overlap, so it is not a personal prediction.
  • Using the score on a patient without a confirmed pulmonary embolism, or in place of clinical judgment. The index is only meant for confirmed cases and supports a decision made by a clinician.

Sources

About this calculator

The Pulmonary Embolism Severity Index (PESI) is a validated clinical prediction rule that estimates 30-day mortality risk in patients diagnosed with acute pulmonary embolism, helping clinicians decide who is safe for outpatient treatment versus who needs hospital admission. The score starts from the patient's age in years and adds points for ten independent risk factors: male sex, cancer, heart failure, chronic lung disease, pulse ≥110/min, systolic blood pressure less than 100 mmHg, respiratory rate ≥30/min, temperature less than 36°C, altered mental status, and oxygen saturation less than 90%.

The total score sorts patients into five risk classes (I through V), with Class I–II considered low-risk (roughly 0–3.5% mortality: about 0–1.6% in Class I and 1.7–3.5% in Class II) and Class IV–V considered high-risk (potentially over 10% mortality). PESI, developed by Aujesky and colleagues and later simplified into the sPESI score, is widely used in emergency medicine following ESC and ACCP pulmonary embolism guidelines — but like any clinical score, it supports rather than replaces physician judgment, and this calculator is not medical advice.

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Comments (1)

  • Editorial team

    Age feeds the score one point per year, so it often drives the class on its own. An 88-year-old woman with every other finding normal scores 88, which is already Class III, while a 40-year-old man with a fast pulse and low blood pressure reaches 40 + 10 + 20 + 30 = 100, still Class III. Read the class next to the individual findings. Which other score, such as sPESI, would you like to see here?

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