Prospective multicenter evaluation of the pulmonary embolism rule-out criteria

Jeffrey Kline, D. M. Courtney, C. Kabrhel, C. L. Moore, H. A. Smithline, M. C. Plewa, P. B. Richman, B. J. O'Neil, K. Nordenholz

Research output: Contribution to journalArticle

208 Citations (Scopus)

Abstract

Backgound: Over-investigation of low-risk patients with suspected pulmonary embolism (PE) represents a growing problem. The combination of gestalt estimate of low suspicion for PE, together with the PE rule-out criteria [PERC(-): age <50 years, pulse <100 beatsmin-1, SaO2 ≥ 95%, no hemoptysis, no estrogen use, no surgery/trauma requiring hospitalization within 4 weeks, no prior venous thromboembolism (VTE), and no unilateral leg swelling], may reduce speculative testing for PE. We hypothesized that low suspicion and PERC(-) would predict a post-test probability of VTE(+) or death below 2.0%. Methods: We enrolled outpatients with suspected PE in 13 emergency departments. Clinicians completed a 72-field, web-based data form at the time of test order. Low suspicion required a gestalt pretest probability estimate of

Original languageEnglish (US)
Pages (from-to)772-780
Number of pages9
JournalJournal of Thrombosis and Haemostasis
Volume6
Issue number5
DOIs
StatePublished - May 2008
Externally publishedYes

Fingerprint

Pulmonary Embolism
Venous Thromboembolism
Hemoptysis
Hospital Emergency Service
Leg
Estrogens
Hospitalization
Outpatients
Wounds and Injuries

Keywords

  • Computerized tomography angiography
  • D-dimer
  • Decision rule
  • Decision-making
  • Diagnosis
  • Medical malpractice
  • Pulmonary embolism
  • Venous thromboembolism

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kline, J., Courtney, D. M., Kabrhel, C., Moore, C. L., Smithline, H. A., Plewa, M. C., ... Nordenholz, K. (2008). Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. Journal of Thrombosis and Haemostasis, 6(5), 772-780. https://doi.org/10.1111/j.1538-7836.2008.02944.x

Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. / Kline, Jeffrey; Courtney, D. M.; Kabrhel, C.; Moore, C. L.; Smithline, H. A.; Plewa, M. C.; Richman, P. B.; O'Neil, B. J.; Nordenholz, K.

In: Journal of Thrombosis and Haemostasis, Vol. 6, No. 5, 05.2008, p. 772-780.

Research output: Contribution to journalArticle

Kline, J, Courtney, DM, Kabrhel, C, Moore, CL, Smithline, HA, Plewa, MC, Richman, PB, O'Neil, BJ & Nordenholz, K 2008, 'Prospective multicenter evaluation of the pulmonary embolism rule-out criteria', Journal of Thrombosis and Haemostasis, vol. 6, no. 5, pp. 772-780. https://doi.org/10.1111/j.1538-7836.2008.02944.x
Kline, Jeffrey ; Courtney, D. M. ; Kabrhel, C. ; Moore, C. L. ; Smithline, H. A. ; Plewa, M. C. ; Richman, P. B. ; O'Neil, B. J. ; Nordenholz, K. / Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. In: Journal of Thrombosis and Haemostasis. 2008 ; Vol. 6, No. 5. pp. 772-780.
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