Pulmonology Book

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Hestia Criteria

Aka: Hestia Criteria, Hestia Score
  1. See Also
    1. Pulmonary Embolism
    2. Pulmonary Embolism Management
    3. Pulmonary Embolism Anticoagulation
    4. Hestia Criteria
    5. Pulmonary Embolism Severity Index (PESI)
  2. Indications
    1. Non-massive Pulmonary Embolism risk stratification for outpatient management
  3. Criteria: All must be absent for a negative Hestia result
    1. Systolic Blood Pressure <100 mmHg (without a history of baseline Hypotension)
    2. Contraindications to Heparin or Low-Molecular Weight Heparin (or other Factor Xa Inhibitor)
      1. Active bleeding
      2. Post-operative High Risk Surgery
      3. Creatinine Clearance <30 ml/min
      4. History of Heparin Induced Thrombocytopenia
      5. Warfarin skin necrosis
    3. Other medical conditions requiring hospital management
    4. Social condition requiring hospitalization (e.g. homeless, non-compliance, Psychosis, Chemical Dependency)
    5. Coagulopathy (INR>1.7)
    6. Thrombocytopenia (Platelet Count <50,000)
    7. Pregnancy
    8. Incarceration
  4. Interpretation
    1. All Hestia Criteria negative
      1. Home management of Pulmonary Embolism is reasonable
  5. References
    1. Zondog (2011) J Thromb Haemost 9(8): 1500-7 +PMID:21645235 [PubMed]

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