Table 1 Clinical tools to aid diagnosis of PE with our recommendation for inclusion
Geneva score | PERC index | Wells’ score | ||||
|---|---|---|---|---|---|---|
Age | > 65 | + 1 | ≥50 | + 1 | N/A | |
Previous VTE | yes | + 3 | yes | + 1 | yes | + 1.5 |
Surgery (under general anaesthesia) or lower limb fracture in past month | yes | + 2 | yes | + 1 | yes | + 1.5 |
Active malignant condition | yes | + 2 | N/A | yes | + 1 | |
Unilateral lower limb pain | yes | + 3 | + 1 | yes | + 3 | |
Haemoptysis | yes | + 2 | yes | + 1 | yes | + 1 |
Heart rate | > 65 | + 3 | ≥100 | + 1 | ≥100 | + 1.5 |
> 95 | + 5 | |||||
Pain on lower limb palpation and unilateral oedema | yes | + 1 | ||||
O2 saturation (room air) | N/A | < 95% | + 1 | N/A | ||
Hormone use | N/A | + 1 | N/A | |||
PE is #1 diagnosis OR equally likely | yes | + 3 | ||||
Pulmonary embolism is likely | < 4 points low risk (7–9%) 4–10 points moderate risk (30%) > 11 points high risk (> 60%) | < 1 the likelihood of PE is < 2%. 1 or above PERC cannot rule out PE | < 2 low risk (1.3%) > 2 moderate risk (16.2%) > 6 points high risk (> 40.6%) | |||
If the patient is low risk, consider the presence of obvious chest wall/spinal deformity before further investigation | ||||||