Advanced Practice: sPESI vs Hestia Criteria for Discharge of Low Risk PE Patients




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



- 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



- 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)



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