PERC rule: Difference between revisions

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Pulmonary Embolism Rule Out (PERC) Criteria
==Background==
*Use only if you would be confident in excluding [[PE]] with a neg D-dimer
*If all are present AND low suspicion for PE, no D-dimer needed:


If all BREATHS are present AND low suspicion for PE, no D-dimer needed:
{{PERC rule}}


B- No blood in sputum
==Validation==
*Validated on 7527 patients
**Only 0.9% had [[PE]] when PERC negative, no deaths


R- room air sat > 95%
==See Also==
[[Pulmonary Embolism (PE)]]


E- No estrogen or hormone use
==External Links==
*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]


A- Age < 50
==See Also==
*[[EBQ:PERC Rule Validation]]


T- No  prior DVT or PE
==References==
<references/>


H- Heart rate < 100bpm
[[Category:Pulmonary]]
 
S- No surgery/trauma requiring hospitalization in past 4 weeks
 
 
Note: Inclusion Criteria
 
Use this criteria if confident in excluding PE with negative D-dimer
 
Patient with dyspnea and PE was not felt to be the most likely Dx:
 
    -very low risk group ~2% overall PE risk
 
 
Note: Exclusion
 
DO NOT use if negative D-dimer does not r/o PE
 
 
Validated on 7527 patients found 96% sensitive in detecting PE
 
0.9% had PE, 0 died when all BREATHS present
 
 
 
 
[[Category:Pulm]]

Latest revision as of 19:23, 27 January 2017

Background

  • Use only if you would be confident in excluding PE with a neg D-dimer
  • If all are present AND low suspicion for PE, no D-dimer needed:

PERC Rule Calculator

Check all of the following that are true:

  • Age <50yr
  • Pulse ox >94% (room air)
  • HR <100
  • No prior PE or DVT
  • No recent surgery or trauma (within prior 4wk)
  • No hemoptysis
  • No estrogen use
  • No unilateral leg swelling

In patients with low suspicion for PE (best-guess pre-test probability <15%) AND all are true, only 0.9% had PE (n=7527) and it can be ruled-out without further testing (i.e. no need for d-dimer)[1][2]

Validation

  • Validated on 7527 patients
    • Only 0.9% had PE when PERC negative, no deaths

See Also

Pulmonary Embolism (PE)

External Links

See Also

References

  1. ↑ Kline JA, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2004; 2: 1247–55.
  2. ↑ Kline JA, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost 2008; 6: 772–80. (PMID: 18318689).
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