Comparative analysis of clinical decision tools for acute pulmonary embolism at a tertiary care center

Acute pulmonary embolism (PE) requires accurate risk stratification to guide intensive care versus safe discharge decisions. Therefore, it is of interest to compare original Pneumonia Severity Index (PESI) versus Simplified Pneumonia Severity Index (sPESI) in 410 acute PE patients for predicting 30-day mortality and adverse outcomes. Both indices showed excellent negative predictive values (NPVs) (>98%) for mortality, with sPESI demonstrating higher sensitivity (94.1% vs 89.5%). Original PESI had slightly superior risk discrimination (AUC 0.78 vs 0.75), but sPESI proved more clinically practical. sPESI advances PE management as the preferred bedside tool for identifying low-risk patients suitable for outpatient care.