cliot (version 1.0.0)

perc_rule_pulmonary_embolism: PERC Rule for Pulmonary Embolism

Description

Calculates the Pulmonary Embolism Rule-out Criteria (PERC) to rule out PE in patients with a low pre-test probability. If all 8 criteria are negative, the risk of PE is considered less than 2%, and no further testing (D-dimer or imaging) is required.

Usage

perc_rule_pulmonary_embolism(age, heart_rate, oxygen_saturation, prior_pe_dvt,
                             recent_trauma_surgery, hemoptysis, exogenous_estrogen,
                             unilateral_leg_swelling)

Value

A list containing:

Result

"PERC Rule Negative" or "PERC Rule Not Met".

Recommendation

Clinical guidance based on the result.

Positive_Criteria

A list of criteria that prevented the rule from being negative.

Arguments

age

Numeric. Patient age in years. (>= 50 is a positive finding).

heart_rate

Numeric. Heart rate in beats per minute. (>= 100 is a positive finding).

oxygen_saturation

Numeric. Oxygen saturation percentage (SaO2). (< 95% is a positive finding).

prior_pe_dvt

Numeric (0 or 1). Prior history of DVT or PE. (1 = Yes).

recent_trauma_surgery

Numeric (0 or 1). Recent trauma or surgery (within 4 weeks) requiring hospitalization. (1 = Yes).

hemoptysis

Numeric (0 or 1). Presence of hemoptysis. (1 = Yes).

exogenous_estrogen

Numeric (0 or 1). Use of exogenous estrogen (OCP, HRT). (1 = Yes).

unilateral_leg_swelling

Numeric (0 or 1). Unilateral leg swelling suggestive of DVT. (1 = Yes).

References

Kline JA, Mitchell AM, Kabrhel C, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2(8):1247-1255. doi:10.1111/j.1538-7836.2004.00790.x

Examples

# Example 1: PERC Negative
# 30yo, HR 80, SaO2 98%, No other factors
perc_rule_pulmonary_embolism(30, 80, 98, 0, 0, 0, 0, 0)

# Example 2: PERC Not Met
# 30yo, HR 80, SaO2 98%, Taking OCP (Estrogen)
perc_rule_pulmonary_embolism(30, 80, 98, 0, 0, 0, 1, 0)