PE-SARD: A Novel Score to Predict Early Bleeding in Acute Pulmonary Embolism

PE, pulmonary embolism,
PE, pulmonary embolism,
French investigators created a novel scoring system, the PE-SARD, to estimate the risk of early major bleeding in patients with acute pulmonary embolism.

A novel scoring system developed by researchers in France, the Pulmonary Embolism Syncope, Anemia, Renal Dysfunction (PE-SARD) bleeding risk score, can estimate the risk of early major bleeding in patients with acute pulmonary embolism, according to the results of a recent study published in the journal CHEST.

A risk scoring system to predict major bleeding events up to hospital discharge was built from a multicenter, prospective, registry including 2754 patients. This scoring system was then validated by bootstrapping in the derivation dataset by sampling with replacement for 500 iterations. The new risk scoring system was then compared to the VTE-BLEED (Venous Thrombo-Embolism Bleed), RIETE (Registro informatizado de la enfermedad tromboembólica en España; Computerized Registry of Patients with Venous Thromboembolism), and BACS (Bleeding, Age, Cancer, and Syncope) models.

Following multivariable regression, 3 predictors were identified for the occurrence of 82 major bleeds. These included syncope, anemia, and renal dysfunction. The PE-SARD bleeding score was calculated by summing all the components, with the presence of syncope, anemia, and renal dysfunction being worth 1.5, 2.5, and 1 point, respectively. Low risk was defined as a score of 0 points, while intermediate risk was from 1.0 to 2.5 points, and high risk greater than 2.5 points. Observed bleeding rates increased with increasing risk group, from 0.97% in the low-risk group to 8.93% in the high-risk group. When observations were compared to other scoring systems, performance of the PE-SARD score was better than that observed with the VTE-BLEED, RIETE, and BACS scores.

The study authors wrote, “The PE-SARD bleeding risk score is an original, user-friendly score to estimate the risk of early major bleeding in patients with acute PE.” They added, “It exhibits better performance compared with existing scoring systems in the PE setting.”

Disclosure: This study was partially supported by Bayer Helathcare and the BMS-Pfizer Alliance. Please see the original reference for a full list of authors’ disclosures.


Chopard R, Piazza G, Falvo N, et al. An original risk score to predict early major bleeding in acute pulmonary embolism: the Syncope, Anemia, Renal Dysfunction (PE-SARD) bleeding score. Chest. 2021;160(5):1832-1843. doi:10.1016/j.chest.2021.06.048