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

Clinical Question

Conclusion

Design

Population Studied

Inclusion Criteria

Exclusion Criteria

.

Baseline Characteristics

Interventions

Outcomes

Primary Outcomes

Secondary Outcomes

Discussion

Criticism

Funding

CME

1

PERC stands for pulmonary embolism rule out criteria. In this study of 8138 patients, 1666 were found to be low clinical suspicion and PERC negative. The conclusion of the study was

patients with a medium probablity of PE and PERC negative can be discharged home
patients with a high probability of PE and PERC positive should be anticoagulated
patients with low probability of PE and PERC negative will have a probability of less than 2% of VTE
PERC failed to be predictive of PE in this cohort of patients

2

PERC consists of the following rules:

Age < 50, HR < 100, O2 sat >95%, No history of DVT/PE, No recent trauma or surgery, no hemoptysis, no exogenous estrogen, no unilateral leg swelling
Age < 65, HR < 100, O2 sat >95%, No history of DVT/PE, No recent trauma or surgery, no hemoptysis, no exogenous estrogen, no unilateral leg swelling
Age < 50, HR < 100, O2 sat >90%, No history of DVT/PE, No recent trauma or surgery, no hemoptysis, no exogenous estrogen, no unilateral leg swelling
Age < 50, HR < 60, O2 sat >95%, No history of DVT/PE, No recent trauma or surgery, no hemoptysis, no exogenous estrogen, no unilateral leg swelling

3

The utility of the PERC rule is greatest in which of the following patients suspected of a pulmonary embolism?

High pretest probability
Intermediate pretest probability
Low pretest probability


Related Publications

  • ACEP clinical policy; Ann Emerg Med 2011; 57:628-650.

Sources