Acute pulmonary embolism (PE) can be classified into risk categories – low, intermediate, and high , according to the risk of complications from the PE and intermediate-risk PE can be further classified into intermediate-low and intermediate-high risk. This categorization focuses on risk of complications resulting from the PE, however, patients with considerable comorbidities may have little reserves and acute PE could cause imminent instability. Accordingly, two patients of similar presentations with regards to PE, and similar PE risk categories bybiomarkers and imaging findings, could have different outcomes. One should therefore be regarded as higher risk than the other. Such example is acute trauma patients. This population is of particular interest due to the relatively high incidence of PE and contraindication to thrombolysis. Because of the increased bleeding risk, trauma patients have been excluded from major trials investigating efficacy and safety of thrombolysis in PE . Moreover, it can be difficult to classify trauma patients correctly within their PE category due to overlapping signs and symptoms of the trauma and PE. For example, pain may inflict tachycardia, multiple ribs fracture with flail chest may lead to desaturation, bleeding may cause dyspnea and hypotension, and all the above may increase biomarker levels in the blood such as troponin. Comorbidities like acute trauma should therefore lead to reclassification of PE. Additional Risk scores aim to provide a different perspective into outcome of patients with PE, but the acute or severe-chronic co-morbidity is not properly reflected in the calculated risk.