ArticleJournal of acute medicine2024
Safety and Diagnostic Utility Pulmonary Embolism Rule-Out Criteria (PERC) and D-Dimer in Emergency Department.
Article in Journal of acute medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic Validation of PERC and Resource Utilization in Suspected Acute Pulmonary Embolism: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Characterization of pulmonary embolism events in patients with suspected pneumonia.Internal and emergency medicine · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: This study aimed to assess the diagnostic value and safety of using Pulmonary Embolism Rule-Out Criteria (PERC) in an emergency care setting. Methods: We conducted a retrospective application of the PERC to the patients suspected of having pulmonary embolism (PE) and who underwent computed tomography pulmonary angiogram (CTPA) Karolinska University Hospital's emergency department (ED) from 2016 to 2017. The patient data, including D-dimer (DD) and ED waiting times were extracted from the Karolinska Venous Thromboembolism cohort (VTE cohort). Results: Among the 295 patients included in the cohort, 34 (11.5%) were diagnosed with PE. Of these 202 (68.5%) patients were PERC-positive, while 93 (31.5%) were PERC-negative. Among the 93 PERC-negative patients, three had PE; resulting in a sensitivity of 91% (95% CI: 0.77-0.97), a specificity of 34% (95% CI: 0.29-0.40), and a false negative rate (FNR) of 8.8%. Combining positive DD and PERC resulted in a sensitivity of 100% (95% CI: 0.86-1.00), a specificity of 23% (95% CI: 0.15-0.34), and no FNR. When patients classified as high risk for PE (determined by clinical gestalt) were excluded, no PEs were missed. The median total ED stay was 450 minutes in patients who underwent CTPA compared to 203 minutes in the reference group ( Conclusions: Using the PERC rule along with DD testing in low-risk patients effectively rules out PE in ED without the need for further testing. Properly using PERC may significantly reduce patients' waiting time in the ED.
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