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Irish Journal of Medical Science (1971 -)

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01-08-2021 | Angiography | Original Article

A retrospective application of the pulmonary embolism rule out criteria (PERC) of the American College of Physicians would reduce the number of CTPAS by 6% without a false negative in an Irish hospital

Authors: Advait Kothare, Muath Abahussain, Nikita Svirkov-Vainberg, Patrick O’Kelly, Galamoyo Nfila, Peadar Gilligan

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2021

Abstract

Background

Internationally, the number of computerised tomographic pulmonary angiographies (CTPAs) being performed to rule out pulmonary embolism (PE) has caused some concern.

Aim

This study was performed to assess if the application of Pulmonary Embolism Rule-out Criteria (PERC) in an Irish Emergency Department (ED) would have helped to safely reduce the number of D-dimer assays and computed tomographic pulmonary angiographies (CTPAs) ordered.

Methods

The PERC was retrospectively calculated in all patients who underwent CTPA for possible PE. It was then established if the application of the PERC as per the American College of Physicians’ (ACP) guidelines would have safely ruled out the need for further imaging.

Results

Of the 529 patients who underwent CTPA in the study, 63 patients (12%) had PE on CTPA. Had the PERC criteria been applied, no patient who had a PE would have been missed. In this study, PERC had 100% sensitivity and 14% specificity.

Discussion/conclusion

Application of the PERC rule, as per the ACP guidelines, would have reduced the number of CTPAs performed by 32 (6%) without missing any patient with a proven pulmonary embolus.

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Title: A retrospective application of the pulmonary embolism rule out criteria (PERC) of the American College of Physicians would reduce the number of CTPAS by 6% without a false negative in an Irish hospital
Authors: Advait Kothare
Muath Abahussain
Nikita Svirkov-Vainberg
Patrick O’Kelly
Galamoyo Nfila
Peadar Gilligan
Publication date: 01-08-2021
Publisher: Springer International Publishing
Keyword: Angiography
Published in: Irish Journal of Medical Science (1971 -) / Issue 3/2021
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-020-02398-x

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Aim

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