PERC rule - Revision history

Danbot: Expand: stepwise application algorithm, validation data, clinical integration with Wells

2026-03-21T01:40:29Z

Expand: stepwise application algorithm, validation data, clinical integration with Wells

← Older revision		Revision as of 01:40, 21 March 2026
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	==Background==		==Background==
	*~~Use only~~ if you would be confident ~~in excluding [[~~PE]] with a ~~neg~~ D-dimer		*Pulmonary Embolism Rule-out Criteria — used to identify patients in whom [[pulmonary embolism]] can be excluded ''without'' D-dimer testing
	*If ~~all~~ are ~~present AND~~ low ~~suspicion for PE~~, no ~~D-dimer~~ needed:		*'''Only apply if clinical gestalt for PE is low''' (i.e., you would be confident PE is excluded with a negative D-dimer)
			*If ALL 8 criteria are met in a low-risk patient, no further workup is needed (negative predictive value >99%)

			==Criteria==
	{{PERC rule}}		{{PERC rule}}

			==Application==
			*'''Step 1:''' Assess clinical probability (gestalt or [[Wells criteria]])
			*'''Step 2:''' If low probability (Wells ≤4), apply PERC
			*'''Step 3:''' If all PERC criteria met → stop workup; no D-dimer needed
			*'''Step 4:''' If any PERC criterion NOT met → obtain [[D-dimer]]
			*'''Do NOT apply PERC''' in moderate or high pre-test probability patients

	==Validation==		==Validation==
	*Validated on ~~7527~~ patients		*Validated on 8,138 patients across 13 EDs
	**Only 0.9% had [[PE]] when PERC negative~~, no deaths~~		*Missed PE rate when PERC-negative with low gestalt: <2% (below the testing threshold)
			*No PE-related deaths in PERC-negative group at 45-day follow-up
	~~==See Also==~~
	~~[[Pulmonary Embolism~~ (PE)]]

	~~==External Links==~~
	*~~[http://www.mdcalc.com/perc~~-~~rule~~-~~for~~-~~pulmonary~~-~~embolism/ MDCalc - PERC for Pulmonary Embolism]~~

	==See Also==		==See Also==
			*[[Pulmonary embolism]]
			*[[Wells criteria]]
			*[[D-dimer]]
	*[[EBQ:PERC Rule Validation]]		*[[EBQ:PERC Rule Validation]]

	==References==		==References==
	<references/>		<references/>

	[[Category:Pulmonary]]		[[Category:Pulmonary]]
			[[Category:Vascular]]

Ostermayer: Text replacement - " PE " to " PE "

2017-01-27T19:23:47Z

Text replacement - " PE " to " PE "

← Older revision		Revision as of 19:23, 27 January 2017
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	==Background==		==Background==
	*Use only if you would be confident in excluding PE with a neg D-dimer		*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 are present AND low suspicion for PE, no D-dimer needed:

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	==Validation==		==Validation==
	*Validated on 7527 patients		*Validated on 7527 patients
	**Only 0.9% had PE when PERC negative, no deaths		**Only 0.9% had [[PE]] when PERC negative, no deaths

	==See Also==		==See Also==

Neil.m.young: Text replacement - "==Source== " to "==References== "

2016-06-25T16:48:04Z

Text replacement - "==Source== <references/>" to "==References== <references/>"

← Older revision		Revision as of 16:48, 25 June 2016
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	*[[EBQ:PERC Rule Validation]]		*[[EBQ:PERC Rule Validation]]

	==~~Source~~==		==References==
	<references/>		<references/>

	[[Category:Pulmonary]]		[[Category:Pulmonary]]

Ostermayer: Text replacement - "Category:Pulm" to "Category:Pulmonary"

2016-03-22T16:11:37Z

Text replacement - "Category:Pulm" to "Category:Pulmonary"

← Older revision		Revision as of 16:11, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Pulm~~]]		[[Category:Pulmonary]]

Rossdonaldson1: Rossdonaldson1 moved page PERC Rule to PERC rule

2015-02-18T19:18:23Z

Rossdonaldson1 moved page PERC Rule to PERC rule

← Older revision	Revision as of 19:18, 18 February 2015
(No difference)

Rossdonaldson1 at 18:22, 18 February 2015

2015-02-18T18:22:41Z

← Older revision		Revision as of 18:22, 18 February 2015
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	==Background==		==Background==
	*Use only if you would be confident in excluding PE with a neg D-dimer		*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:

	~~==Criteria==~~		{{PERC rule}}
	*If all are present AND low suspicion for PE, no D-dimer needed:
	~~#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~~

	==Validation==		==Validation==
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	==External Links==		==External Links==
	*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]		*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]

	~~{{PERC rule}}~~

	==See Also==		==See Also==

Rossdonaldson1 at 18:17, 18 February 2015

2015-02-18T18:17:53Z

← Older revision		Revision as of 18:17, 18 February 2015
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	{{PERC rule}}		{{PERC rule}}

			==See Also==
			*[[EBQ:PERC Rule Validation]]

	==Source==		==Source==
	*[[EBQ:PERC Rule Validation]]
	<references/>		<references/>

	[[Category:Pulm]]		[[Category:Pulm]]

Rossdonaldson1: /* Source */

2015-02-18T18:17:29Z

Source

← Older revision		Revision as of 18:17, 18 February 2015
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	==Source==		==Source==
	*Tintinalli
	*[[EBQ:PERC Rule Validation]]		*[[EBQ:PERC Rule Validation]]
			<references/>

	[[Category:Pulm]]		[[Category:Pulm]]

Rossdonaldson1 at 18:08, 18 February 2015

2015-02-18T18:08:45Z

← Older revision		Revision as of 18:08, 18 February 2015
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	==External Links==		==External Links==
	*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]		*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]

			{{PERC rule}}

	==Source==		==Source==

Bobzmac: added external links sections

2014-05-04T04:02:00Z

added external links sections

← Older revision		Revision as of 04:02, 4 May 2014
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	==See Also==		==See Also==
	[[Pulmonary Embolism (PE)]]		[[Pulmonary Embolism (PE)]]

			==External Links==
			*[http://www.mdcalc.com/perc-rule-for-pulmonary-embolism/ MDCalc - PERC for Pulmonary Embolism]

	==Source==		==Source==