PE Risk Stratification
Research also shows that decision rules incorporating lengthy prediction rules (such as the Wells rule) are seldom used by emergency physicians because of rule complexity, rule credibility, and local culture - Kerstin de Wit MD
image by: MDCalc
Clinical decision rules developed for risk stratification of suspected PE include Wells Criteria for PE as well as the Pulmonary Embolism Rule Out Criteria ( PERC). These rules can help guide diagnostic testing. Well’s uses clinical features to determine low, moderate, or high-risk patients.
In patients who are low risk according to Wells, the PERC criteria may be applied. If a patient is low risk according to Wells and meets all of the PERC criteria, they are considered very low risk for PE and would not benefit from—and may actually be harmed by—further testing. Patients who are moderate risk for PE according to Wells should undergo d-dimer testing. In most patients the threshold…
These risk stratification tools have not been verified in pregnancy and caution should be given to applying them to these patients. Compared with nonpregnant women, the risk of venous thromboembolism increases fivefold during pregnancy and is increased by 60-fold in the first 3 months after delivery.
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