Reminder that the Bova Score (2 points each for heart rate over 110, SBP less than 90, RV strain on CT or echo, and elevated troponin) along with an elevated lactate and BNP can help predict outcomes in hemodynamically stable PE patients.
"Low risk (score <2):
Proceed with standard anticoagulation therapy. Standard outpatient or inpatient monitoring, as appropriate.
Intermediate risk (score 3–4): Consider closer monitoring (e.g., stepdown/ICU). Discuss the possibility of advanced therapies (e.g., thrombolysis) in select cases, especially if clinical status worsens.
High risk (score >4): Maintain continuous ICU monitoring with a clear plan for rapid intervention if clinical status worsens (e.g., hypotension, worsening hypoxia, arrhythmias). Strongly consider multidisciplinary team involvement and potential advanced therapies (e.g., systemic thrombolysis or catheter-directed therapies)."
References
https://www.mdcalc.com/calc/4004/bova-score-pulmonary-embolism-complications