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Pulmonary embolism rule-out criteria (the PERC rule)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Pulmonary embolism rule-out criteria (the PERC rule)

[1] The clinician estimates the likelihood of PE to be less than 15% based on the overall clinical impression and other diagnoses are feasible.

NICE noted that "In people with signs or symptoms of PE, but in whom clinical suspicion of PE is low (the clinician estimates the likelihood of PE to be less than 15% based on the overall clinical impression and other diagnoses are feasible), there was some evidence showing that the PERC rule can accurately eliminate PE as a possible diagnosis. The committee agreed that using the PERC rule can reduce anxiety and avoid unnecessary D-dimer testing, imaging and interim anticoagulation treatment for people with a low probability of PE and none of the PERC criteria for PE. However, the evidence was limited so the committee agreed to recommend that the PERC rule be considered as part of initial assessment."

Be aware that the PERC rule has not been validated in people with COVID-19 (1).

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