EBQ:PERC Rule Validation
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Under Review Journal Club Article
Kline J.A. et al. "Prospective multicenter evaluation of the pulmonary embolism rule-out criteria". Journal of Thrombosis and Haemostasis. 2008. 6(5):772–780.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Can risk stratification to low risk for pulmonary embolism (PE) in combination with a negative Pulmonary Embolism Rule Out Criteria (PERC) score reduce the probability of PE to less than 2%?
Conclusion
The combination of gestalt estimate of low suspicion for PE and PERC(-) reduces the probability of VTE to below 2% in about 20% of outpatients with suspected PE.
Design
Population Studied
Inclusion Criteria
Exclusion Criteria
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Baseline Characteristics
Interventions
Outcomes
Primary Outcomes
Secondary Outcomes
Discussion
- Is the patient older than 49 years of age?
- Is the pulse rate above 99 beats min)1?
- Is the pulse oximetry reading <95% while the patient breathes room air?
- Is there a present history of hemoptysis?
- Is the patient taking exogenous estrogen?
- Does the patient have a prior diagnosis of venous thromboembolism (VTE)?
- Has the patient had recent surgery or trauma? (Requiring endotracheal intubation or hospitalization in the previous 4 weeks.)
- Does the patient have unilateral leg swelling? (Visual observation of asymmetry of the calves.)
Criticism
Funding
CME
Related Publications
- ACEP clinical policy; Ann Emerg Med 2011; 57:628-650.