Hestia Criteria for Outpatient PE Treatment
11 clinical criteria to determine if a patient with acute PE is safe for outpatient (home) treatment. If ANY criterion is met, outpatient treatment is NOT recommended.
Score interpretation
No Hestia criteria met. Patient may be suitable for home treatment.
→ Start DOAC (rivaroxaban 15mg bd × 3/52 then 20mg od, or apixaban 10mg bd × 7/7 then 5mg bd). Arrange 24–48h follow-up. Safety-net for deterioration.
One or more Hestia criteria met. Inpatient treatment is recommended.
→ Admit for monitoring and anticoagulation. Manage triggering criterion. Review for intermediate-/high-risk PE pathway.
Interpretation bands for the Hestia. Apply clinical judgement and local guidance.
References
- Zondag W, et al. Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study. J Thromb Haemost. 2011;9(8):1500–1507.
Related
Curated clinical cross-links plus same-class fallbacks.
- Edoxaban (VTE Treatment/PE — Vascular) · Direct Factor Xa Inhibitor (DOAC)
- Nitric Oxide (Inhaled — iNO) · Selective Pulmonary Vasodilator
- Selexipag · Pulmonary Arterial Hypertension
- Macitentan · Pulmonary Arterial Hypertension
- Thiamine (IV/IM — Pabrinex) · Vitamin B1 (Thiamine) — deficiency treatment / Wernicke's encephalopathy prevention
- Dextrose 10% IV · IV glucose solution (hypoglycaemia treatment)
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.