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Use of the pulmonary embolism rule-out criteria (PERC) can decrease the number of unnecessary computed tomography pulmonary angiography (CTPA) tests performed on low-risk patients in the emergency department.

PE, the formation of a blood clot in the lung, is the third-leading cardiovascular cause of death. CTPA is an advanced imaging test that is used to obtain images of the pulmonary arteries and diagnose PE. "PERC encompasses eight simple criteria that can be garnered within the first few minutes of patient contact. If all criteria are absent in a low-risk patient, then PE is essentially excluded," said Justin LaPlante, MD, lead author of the study.

The study, performed at Riverside Regional Medical Center in Newport News, VA, included 206 patients that underwent a PERC evaluation and CTPA for the detection of a suspected PE. Results showed that 27 of those patients had a PERC score that would have excluded a PE. "Implementing the PERC rule in a clinical decision algorithm would have reduced the number of unnecessary CTPA exams by 13 percent," said LaPlante.

"Reducing the number of unnecessary computed tomography pulmonary angiography (CTPA) exams minimizes radiation exposure to the patient without altering mortality, reduces costs for both the patient and hospital, and allows the clinician to begin working down a different differential diagnostic pathway once PE is ruled out," he said.

This study was presented at the ARRS 2010 Annual Meeting in San Diego, CA.

Source: ARRS

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