cliot (version 1.0.0)

pesi_score: Pulmonary Embolism Severity Index (PESI)

Description

Calculates the Pulmonary Embolism Severity Index (PESI) to stratify the risk of 30-day mortality in patients with confirmed pulmonary embolism (PE). The score sums points derived from 11 clinical variables (demographics, comorbidities, and vital signs).

Usage

pesi_score(age, sex, cancer_history, heart_failure_history, chronic_lung_disease,
           heart_rate, systolic_bp, respiratory_rate, temperature,
           altered_mental_status, oxygen_saturation)

Value

A list containing:

PESI_Score

The calculated total score.

Risk_Class

The risk classification (Class I - V).

Est_30_Day_Mortality

Estimated 30-day all-cause mortality percentage.

Recommendation

Clinical guidance on site of care (Outpatient vs. Inpatient).

Arguments

age

Numeric. Patient age in years. (Points = Age in years).

sex

String. Patient sex ("Male" or "Female"). (Male adds 10 points).

cancer_history

Numeric (0 or 1). History of cancer. (1 = Yes, +30 points).

heart_failure_history

Numeric (0 or 1). History of heart failure. (1 = Yes, +10 points).

chronic_lung_disease

Numeric (0 or 1). History of chronic lung disease. (1 = Yes, +10 points).

heart_rate

Numeric. Heart rate in beats per minute. (>= 110 bpm adds 20 points).

systolic_bp

Numeric. Systolic blood pressure in mmHg. (< 100 mmHg adds 30 points).

respiratory_rate

Numeric. Respiratory rate in breaths per minute. (>= 30 bpm adds 20 points).

temperature

Numeric. Body temperature in degrees Celsius. (< 36 C adds 20 points).

altered_mental_status

Numeric (0 or 1). Altered mental status (disorientation, lethargy, stupor, or coma). (1 = Yes, +60 points).

oxygen_saturation

Numeric. Arterial oxyhemoglobin saturation (%). (< 90% adds 20 points).

References

Aujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med. 2005;172(8):1041-1046. doi:10.1164/rccm.200506-862OC

Examples

# Example 1: High Risk (Class V)
# 80yo Male (+10), Altered Mental Status (+60), SBP 90 (+30)
# Score = 80 + 10 + 60 + 30 = 180
pesi_score(80, "male", 0, 0, 0, 100, 90, 20, 37, 1, 95)

# Example 2: Low Risk (Class II)
# 50yo Female, History of Cancer (+30), stable vitals
# Score = 50 + 0 + 30 = 80
pesi_score(50, "female", 1, 0, 0, 80, 120, 16, 37, 0, 98)