Evaluation of Pulmonary Embolism Severity Index, Simplified Pulmonary Embolism Severity Index and Hestia criteria in pulmonary embolism patients

Şener, P. Evaluation of Pulmonary Embolism Severity Index, Simplified Pulmonary Embolism Severity Index and Hestia Criteria in Pulmonary Embolism Patients. Eskişehir Osmangazi University, Faculty of Medicine, Department of Chest Diseases, Medical Specialization Thesis, Eskişehir, 2025. Pulmonary embolism (PE) is a preventable disease that can recur and has high mortality and morbidity. The aim of our study was to evaluate PESI, sPESI classifications and Hestia criteria in determining mortality and prognostic factors in patients with acute PE. For this purpose, 378 acute PE patients were included in the study. 52.1% of the patients were female, 47.9% were male, and the mean age was 67.62±15.72 years. Patients were divided into 5 groups according to the PESI classification. According to sPESI and Hestia, they were grouped as low and high risk. Major bleeding was detected in 6.1% of the patients, PE recurrence was detected in 1.1%, and 24.6% were mortal. Age over 80, presence of cancer, hemodynamic instability, oxygen requirement, right ventricular failure findings and troponin elevation were found to be significant with mortality. In multiple logistic regression analysis, only troponin elevation was significant (p=0.034). Although PESI, sPESI classification and Hestia criteria had similar sensitivity and negative predictive value in predicting 30-day mortality, only PESI classification was found to be significant according to logistic regression analysis (p=0.002). Although Hestia criteria were shown to be able to identify low-risk PE patients with high sensitivity and negative predictive value, it was seen that the evaluation of PE patients in the high-risk group and its prognostic performance needed to be confirmed and improved. A new model was created by combining PESI risk classification with cardiac troponin and right insufficiency findings. This new model has been shown to provide greater benefits in risk stratification of patients and improving the decision making process accordingly. Key Words: Pulmonary embolism, PESI, sPESI, Hestia