The pulmonary embolism rule-out criteria (PERC) rule does not safely exclude pulmonary embolism.

Détails

ID Serval
serval:BIB_BD8EFDCACE04
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The pulmonary embolism rule-out criteria (PERC) rule does not safely exclude pulmonary embolism.
Périodique
Journal of Thrombosis and Haemostasis
Auteur(s)
Hugli O., Righini M., Le Gal G., Roy P.M., Sanchez O., Verschuren F., Meyer G., Bounameaux H., Aujesky D.
ISSN
1538-7836 (Electronic)
ISSN-L
1538-7836
Statut éditorial
Publié
Date de publication
2011
Volume
9
Numéro
2
Pages
300-304
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Background: The Pulmonary Embolism Rule-out Criteria (PERC) rule is a clinical diagnostic rule designed to exclude pulmonary embolism (PE) without further testing. We sought to externally validate the diagnostic performance of the PERC rule alone and combined with clinical probability assessment based on the revised Geneva score. Methods: The PERC rule was applied retrospectively to consecutive patients who presented with a clinical suspicion of PE to six emergency departments, and who were enrolled in a randomized trial of PE diagnosis. Patients who met all eight PERC criteria [PERC(-)] were considered to be at a very low risk for PE. We calculated the prevalence of PE among PERC(-) patients according to their clinical pretest probability of PE. We estimated the negative likelihood ratio of the PERC rule to predict PE. Results: Among 1675 patients, the prevalence of PE was 21.3%. Overall, 13.2% of patients were PERC(-). The prevalence of PE was 5.4% [95% confidence interval (CI): 3.1-9.3%] among PERC(-) patients overall and 6.4% (95% CI: 3.7-10.8%) among those PERC(-) patients with a low clinical pretest probability of PE. The PERC rule had a negative likelihood ratio of 0.70 (95% CI: 0.67-0.73) for predicting PE overall, and 0.63 (95% CI: 0.38-1.06) in low-risk patients. Conclusions: Our results suggest that the PERC rule alone or even when combined with the revised Geneva score cannot safely identify very low risk patients in whom PE can be ruled out without additional testing, at least in populations with a relatively high prevalence of PE.
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/03/2011 16:24
Dernière modification de la notice
20/08/2019 16:31
Données d'usage