| Differentiating low-risk and no-risk PE patients: the PERC score. | |
| | |
MedLine Citation:
|
PMID: 19097732 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Pulmonary embolism (PE) remains one of the most challenging diagnoses in emergency medicine. The Pulmonary Embolism Rule-out Criteria (PERC) score, a decision aid to reliably distinguish low-risk from very low-risk PE patients, has been derived and validated. CLINICAL QUESTION: Can a subset of patients with sufficiently low risk for PE be identified who require no diagnostic testing? EVIDENCE REVIEW: The PERC score derivation and validation trials were located using PubMed and Web of Science. A critical appraisal of this research is presented. RESULTS: One single-center and another multi-center validation trial both confirmed that the eight-item PERC score identified a very low-risk subset of patients in whom PE was clinically contemplated with a negative likelihood ratio 0.17 (95% confidence interval 0.11-0.25) in the larger trial. If applied, the rule would have identified 20% of potential PE patients as very low risk. CONCLUSION: The PERC score provides clinicians with an easily remembered, validated clinical decision rule that allows physicians to forego diagnostic testing for pulmonary embolus in a very low-risk population. |
| | |
Authors:
|
Christopher R Carpenter; Samuel M Keim; Rawle A Seupaul; Jesse M Pines; |
Publication Detail:
|
Type: Case Reports; Journal Article Date: 2008-12-20 |
Journal Detail:
|
Title: The Journal of emergency medicine Volume: 36 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-03-30 Completed Date: 2009-08-17 Revised Date: 2011-08-25 |
Medline Journal Info:
|
Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
|
Languages: eng Pagination: 317-22 Citation Subset: IM |
Affiliation:
|
Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antifibrinolytic Agents / diagnostic use Diagnosis, Differential Emergency Service, Hospital False Positive Reactions Female Fibrin Fibrinogen Degradation Products / diagnostic use Humans Oximetry Pulmonary Embolism / diagnosis* Risk Assessment* Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
|
0/Antifibrinolytic Agents; 0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Nitroglycerin and Epinephrine Improve Coronary Perfusion Pressure in a Porcine Model of Ventricular ...
Next Document: Early Norepinephrine Infusion Delays Cardiac Arrest after Hemorrhagic Shock in Rats.