Advanced Practice: sPESI vs Hestia Criteria for Discharge of Low Risk PE Patients
Study:
Quezada, Carlos Andrés, et al. "Accuracy and interobserver reliability of the simplified pulmonary embolism severity index versus the hestia criteria for patients with pulmonary embolism." Academic Emergency Medicine (2018).
Outcome measure:
Compare the accuracy and interobserver reliability of the sPESI and Hestia criteria for predicting short term mortality in patients with pulmonary embolism
Methods:
- Prospective cohort study, single center (large/tertiary/academic center)
- 488 adult patients diagnosed with symptomatic PE in the ED
- Compared sPESI and Hestia criteria accuracy for 30 day all cause mortality and interobserver reliability for classifying patients as low or high risk
Results:
- sPESI and Hestia both classified approximately one quarter of patients as low risk (28% vs 27%, respectively)
- Patients classified as low risk had similar rate of all cause mortality with no statistical difference (sPESI 0.7% vs Hestia 2.3%)
- Both had good interobserver reliability (disagreement in 1.2% with sPESI and 7.6% with Hestia)
Conclusion:
Both tools identified similar numbers of patients as low risk and both had similar 30 day all cause mortality, interobserver reliability was better with sPESI