PERC rule

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

External Links

MDCalc - PERC for Pulmonary Embolism

References

↑ 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.
↑ Kline JA, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost 2008; 6: 772–80. (PMID: 18318689).

Authors:

[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).

[1]

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