Calculate PESI from age, history, vital-sign thresholds, and examination findings.
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PESI
Calculated result
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Complete every required field, then select the calculate button.
PESI scoreWeighted sum of demographic and clinical factors
Score
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Risk class
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Educational estimate only—not medical advice, a diagnosis, or a treatment instruction. PESI is used after pulmonary embolism is diagnosed and cannot replace urgent assessment or a full treatment decision.
The Pulmonary Embolism Severity Index (PESI) adds age, medical history and bedside findings to place an adult with confirmed acute pulmonary embolism into one of five prognostic classes. Its established purpose is risk stratification for early mortality after diagnosis, especially identification of people in lower-risk classes.
PESI does not diagnose or exclude a pulmonary embolism. It also does not decide treatment or outpatient care by itself. Hemodynamic status, bleeding risk, right-ventricular findings, biomarkers, social circumstances and clinical judgment can change management. Anyone with severe breathing difficulty, chest pain, fainting, blue or grey skin, confusion or another emergency symptom needs urgent medical care.
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How to Use This Calculator
Enter age in completed years and select sex as used by the original published score. Age supplies the starting number of points; male sex adds 10.
Mark each history item only when the patient meets its clinical definition: cancer adds 30, heart failure adds 10, and chronic lung disease adds 10.
Mark current findings from the assessment: pulse at least 110 adds 20; systolic pressure below 100 mmHg adds 30; respiratory rate at least 30 adds 20; temperature below 36°C adds 20; altered mental status adds 60; oxygen saturation below 90% adds 20.
Choose Calculate. The points are summed and assigned to Class I through V.
Have a qualified clinician interpret the class alongside the full acute-PE assessment. Do not delay evaluation to complete the form.
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Formula Used
PESI score = age in years + 10 if male + 30 for cancer + 10 for heart failure + 10 for chronic lung disease + 20 for pulse ≥110/min + 30 for systolic BP <100 mmHg + 20 for respiratory rate ≥30/min + 20 for temperature <36°C + 60 for altered mental status + 20 for oxygen saturation <90%. Classes: I ≤65; II 66–85; III 86–105; IV 106–125; V >125.
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Variables Explained
Criterion
Points
Entry reminder
Age
Years
Completed years, ages 18–120 on this page.
Male sex
10
Original-score category.
Cancer
30
Use the clinical definition, not suspicion alone.
Heart failure
10
Documented history.
Chronic lung disease
10
Documented history.
Pulse ≥110/min
20
Current measured finding.
Systolic BP <100 mmHg
30
Current measured finding.
Respiratory rate ≥30/min
20
Current measured finding.
Temperature <36°C
20
Current measured finding.
Altered mental status
60
Disorientation, lethargy, stupor or coma.
O₂ saturation <90%
20
Current measured finding.
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Worked Example
Consider a 60-year-old woman with a history of cancer and a temperature below 36°C, with “No” selected for all other criteria. The score is 60 for age + 30 for cancer + 20 for low temperature = 110 points. That falls in Class IV (high risk), the 106–125 range.
This class describes prognosis in studied groups with acute pulmonary embolism. It does not give an individual certainty and cannot replace immediate assessment of instability or other clinical evidence.
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Why Use This Calculator?
Classes I and II are the lower-score groups; classes III through V have progressively higher observed early mortality in validation cohorts. Current guidance still combines a severity score with other information. A low PESI does not override shock, right-ventricular dysfunction, biomarker findings, major bleeding risk or a reason that home care is unsafe.
The original PESI differs from simplified PESI. Do not compare the numeric totals directly: sPESI uses six one-point criteria and a different split. Confirm which tool a guideline, record or study names.
Measurements can change during acute illness. Use contemporaneous, clinically verified values and follow local guidance on repeat assessment. The displayed label is educational support for professional review, not a diagnosis, discharge instruction or treatment recommendation.
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Common Mistakes
Using PESI before pulmonary embolism has been diagnosed to estimate whether PE is present.
Confusing original PESI points with the simplified one-point score.
Entering an old vital sign instead of the current clinical finding.
Adding 30 rather than 20 points for temperature below 36°C.
Reading a lower class as proof that outpatient care is safe.
Ignoring hemodynamic instability, imaging, biomarkers or bleeding risk.
Delaying emergency assessment while gathering values for the score.
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Frequently Asked Questions
Can PESI tell me whether I have a pulmonary embolism?
No. It is a prognosis score used after acute PE is confirmed. Suspected PE requires prompt medical assessment and appropriate diagnostic testing.
Is PESI the same as simplified PESI?
No. The original tool starts with age and uses weighted criteria. The simplified version uses six one-point items and has a different interpretation.
Does Class I or II automatically mean home treatment?
No. A clinician must also consider stability, right-heart assessment where relevant, bleeding risk, other illnesses, support and follow-up.
Why does age add so many points?
In the original model, age in years is the baseline score. That reflects the model derived from patient outcomes; it is not a statement that age alone determines care.
What counts as altered mental status?
The criterion includes disorientation, lethargy, stupor or coma in the original score. A clinician should establish whether it is present.
What if a vital sign changes after calculation?
Seek clinical reassessment. Acute PE status can evolve, and an earlier score must not be used to dismiss new deterioration.
Can I use the mortality ranges to predict one person’s outcome?
No. Published ranges describe groups and vary across populations. They do not provide certainty for an individual patient.