• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Pulmonary Embolism Rule-out Criteria non-inferior to usual care for patients at low-risk for pulmonary embolism

byDaniel Fisher
February 14, 2018
in Cardiology, Emergency, Imaging and Intervention, Public Health, Pulmonology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In this multicenter, randomized controlled study, the Pulmonary Embolism Rule-out Criteria (PERC) was not associated with an inferior rate of diagnosing thromboembolic events in low risk patients compared to care as usual.

2. The PERC strategy resulted in significantly fewer uses of CT pulmonary angiography, reduced ED length of stay, and fewer hospital admissions than usual care.

Evidence Rating Level: 2 (Excellent)

Study Rundown: The diagnostic strategy for Pulmonary Embolisms (PEs) is well established in the ED, consisting of D-dimer and subsequent CT Pulmonary Angiography (CTPA) as usual care. However, in patients who are determined to be of low-risk by clinicians, it is unclear if these diagnostic tests are over utilized. In this French, multicenter, randomized controlled trial, patients who were deemed by clinicians to have low probability of PE were worked-up for the presence of PE according to usual care or the clinical rule PE Rule-out Criteria (PERC). PERC did not result in an inferior rate of PE diagnosis compared to care as usual. In addition, PERC resulted in significantly fewer uses of CTPA, reduced ED length of stay, and fewer hospital admissions than care as usual. There was no significant difference in all-cause mortality between groups.

This trial supports the hypothesis that among patients with a low risk of PE, clinical rule out criteria may be just as effective as usual care but may result in fewer resources utilized. In addition, PEs that may be present even in these low risk patients tended to be segmental, which rarely need intervention. Though these results support use of such a clinical rule for this patient population, the economic benefit of this approach should be assessed, and the study should be repeated in other populations to increase its generalizability.

Click to read the study, published in JAMA

RELATED REPORTS

Reduced-dose apixaban noninferior to full dose for cancer-associated thrombosis

#VisualAbstract: Reduced-Dose Apixaban was Noninferior to Full-Dose for Cancer-Associated Venous Thromboembolism

#VisualAbstract: Reduced-Dose was Not Non-Inferior to Full-Dose Direct Oral Anticoagulants in Venous Thromboembolism Patients

Relevant Reading: Prospective multicenter evaluation of the pulmonary embolism rule-out criteria

In-Depth [randomized controlled trial]: A total of 1749 patients with low-risk of PE (15% by clinical gestalt) were included from 14 French EDs for this non-inferiority, crossover clustered-randomized controlled trial. For 6 months of the trial, patients received care as usual for work-up of PE, involving D-dimer followed by CTPA. For the other 6 months, patients were evaluated with the PERC rule and were only followed up with usual care if PERC score was >0. A two-month washout period was present between the two study periods, and each ED was randomized to start with PERC or usual care before switching to the opposite strategy during the second half of the trial. PE was diagnosed at 1.5% in the PERC group and 2.7% in the usual care group for a difference of 1.3% (CI95 -0.1 to 2.7%), though total thromboembolic events in the subsequent 3 months was non-inferior with a difference between groups of 0.1% (CI95 -∞ to 0.8%). Patients in the PERC group were less likely to undergo CTPA (difference 9.7%; CI95 6.1 to 13.2%), had reduced ED stays (p < 0.001), and fewer hospital admissions (difference 3.3%; CI95 0.1 to 6.6%) than the usual care group. Post-hoc sensitivity analyses revealed similar results.

Image: CC/Wiki

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: healthcare costspulmonary embolismvenous thromboembolism
Previous Post

2 Minute Medicine Rewind February 12, 2018

Next Post

Affordable Care Act likely to lead to better prenatal care for women under 26

RelatedReports

Thrombophilia-associated stillbirth risk appears limited to factor V Leiden
Hematology

Reduced-dose apixaban noninferior to full dose for cancer-associated thrombosis

May 20, 2025
#VisualAbstract: Dapagliflozin Reduced Death and Worsening Heart Failure in Transcatheter Aor-tic-Valve Implantation
StudyGraphics

#VisualAbstract: Reduced-Dose Apixaban was Noninferior to Full-Dose for Cancer-Associated Venous Thromboembolism

April 22, 2025
#VisualAbstract: Reduced-Dose was Not Non-Inferior to Full-Dose Direct Oral Anticoagulants in Venous Thromboembolism Patients
StudyGraphics

#VisualAbstract: Reduced-Dose was Not Non-Inferior to Full-Dose Direct Oral Anticoagulants in Venous Thromboembolism Patients

March 10, 2025
Patient Basics: Colonoscopy
Oncology

Cancer screening costs in the United States may exceed $40 billion annually

August 14, 2024
Next Post
USPSTF finds insufficient evidence for screening for iron deficiency anemia during pregnancy

Affordable Care Act likely to lead to better prenatal care for women under 26

Influenza vaccine not associated with increased risk of epilepsy in children

Influenza vaccine not associated with increased risk of epilepsy in children

Childhood asthma rates decreasing, except among the poor

Nusinersen improves motor function in children with later-onset spinal muscular atrophy: The CHERISH trial

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure
  • Nerandomilast slows decline in FVC in idiopathic pulmonary fibrosis
  • Mazdutide significantly reduces weight in adults with overweight or obesity
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.