Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients

French RCT (n=1916) found PE rule-out criteria (PERC) vs conventional strategy did not result in inferior rate of thromboembolic events over 3 months among very low-risk patients with suspected PE (diagnosed at initial presentation in 14 (1.5%) vs 26 (2.7%),respectively; p=0.052)

The PERC rule is an 8-item set of clinical criteria that includes arterial oxygen saturation of 94% or less, pulse rate of at least 100/min, patient age of 50 years or older, unilateral leg swelling, haemoptysis, recent trauma or surgery, prior PE or DVT, and exogenous oestrogen use.

 

An editorial notes this trial shows that cost-free and immediately available data safely excluded PE in low-risk patients treated in French emergency departments and was associated with an 8% decrease in unnecessary CT scanning and a median 40-minute decrease in length of stay. It suggests this information may be useful for clinical decision making involving patients with low risk of PE and may serve to help reduce overtesting for these patients.