🏠 Hestia Criteria (Outpatient PE)
Select patients for outpatient pulmonary embolism treatment with the Hestia criteria.
Hestia Criteria (Outpatient PE)
Haemodynamically unstable
Thrombolysis/embolectomy needed
Active bleeding / high bleeding risk
O₂ needed to keep SaO₂ > 90% for > 24 h
PE diagnosed on anticoagulation
Severe pain needing IV analgesia > 24 h
Medical/social reason for admission > 24 h
CrCl < 30 mL/min
Severe hepatic impairment
Pregnant
History of HIT
When to use
Decide whether home management of PE is appropriate.
How it works
Eleven yes/no criteria; any single 'Yes' makes outpatient management unsuitable.
Key points
- No criterion met → outpatient treatment is often feasible.
- Captures instability, bleeding risk and practical barriers.
- An alternative to sPESI-based pathways.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.