Hestia_Criteria_for_Outpatient_Pulmonary_Embolism_Treatment v.1

Hemodynamically unstable (sBP <100 mmHg and HR >100, needing ICU care, or by clinician judgment)

Thrombolysis or embolectomy needed (For reasons other than hemodynamic instability)

Active bleeding or high risk for bleeding (GI bleeding or surgery ≤2 weeks ago or by clinician judgment)

>24 hrs on supplemental oxygen required to maintain SaO₂ >90%

PE diagnosed while on anticoagulation

Severe pain needing IV pain medication required >24 hr

Medical or social reason for admission >24 hr (infection, malignancy, no support system)

Creatinine clearance <30 mL/min by Cockcroft-Gault

Severe liver impairment (By clinician judgment)

Pregnant

Documented history of heparin-induced thrombocytopenia (HIT)

Identifies low-risk PE patients safe for outpatient treatment.

Henrik Honkanen

henrik.honkanen@stud.ki.se

@Cambio CDS

Used to identify low-risk pulmonary embolism patients safe for outpatient treatment based on Hestia criteria

Use in hemodynamically stable patients with acute pulmonary embolism (PE). The guideline consists of 11 criteria. If ≥1 of criteria present, patient is not eligible for outpatient management by Hestia Criteria. Score interpretation: -0 points. Low risk. Patient eligible for outpatient treatment (0% mortality, 2% VTE recurrence) ->0 points. Not low risk. Patient not eligible for outpatient treatment per the Hestia Criteria, which recommends admission and inpatient treatment

1. Zondag W, Mos IC, Creemers‐Schild D, Hoogerbrugge AD, Dekkers OM, Dolsma J, Eijsvogel M, Faber LM, Hofstee HM, Hovens MM, Jonkers GJ. Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study. Journal of thrombosis and haemostasis. 2011 Aug;9(8):1500-7.

OBSERVATION.hestia_criteria_for_outpatient_pulmonary_embolism_treatment.v0

CDS App Challenge About us