A clinical prediction model was sensitive but not specific for predicting mortality in pulmonary embolism.

M e t h o d s Design: 2 cohort studies, 1 for derivation and 1 for validation. Setting: 186 hospitals in Pennsylvania, United States (derivation cohort), and emergency departments of 117 hospitals in France and Belgium (validation cohort). Patients: 10 534 adults discharged from hospital (53% > 65 y of age, 60% women) with a diagnosis of PE (derivation cohort). 367 patients (69% > 65 y of age, 62% women) with objectively confirmed PE (validation cohort). Description of prediction guide: The 11 predictors in the model were age (number of points = age); male sex (10 points); presence of cancer (30 points), heart failure (10 points), or chronic lung disease (10 points); pulse ≥ 110 beats per minute (20 points); systolic blood pressure < 100 mm Hg (30 points); respiratory rate ≥ 30 breaths per minute (20 points); temperature < 36 ° C (20 points); altered mental status (i.e., disorientation, lethargy, stupor, or coma) (60 points); and arterial oxygen saturation < 90% (20 points). The range of risk scores was divided into quintiles: class I (≤ 65 points, very low risk), class II (66 to 85 points, low risk), class III (86 to 105 points, intermediate risk), class IV (106 to 125 points, high risk), and class V (> 125 points, very high risk). Outcomes: All-cause mortality at 90 days.