Pulmonary Embolism Rule-Out Criteria Stand Up to Scrutiny

Among extremely low-risk patients, application of PERC was very safe in this European sample.

The PERC (pulmonary embolism rule-out criteria) rule stipulates no testing for PE if all eight criteria are fulfilled:

Oxygen saturation >94%
Heart rate <100 beats/minute
Age <50 years
No unilateral leg swelling
No hemoptysis
No recent trauma or surgery
No prior PE or deep venous thrombosis
No exogenous estrogen use

Prior studies in Europe found the PERC rule missed many cases of PE, even though it seemed to be safe in the U.S. Now investigators in France report results of a cluster-randomized noninferiority trial that compared the PERC rule versus standard care for management of patients with very low clinical probability of PE (treating clinician's gestalt estimate of <15%). Fourteen emergency departments (EDs) in France were randomized to use the…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Pulmonary Embolism Rule-Out Criteria Stand Up to Scrutiny

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Reviewing Author