EBQ:PERC Rule Validation

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

Population Studied

Exclusion Criteria

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Related Publications

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

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