MDCalc

Altitude-Adjusted PERC Rule

Rules out PE if no criteria are present; includes SaO2 adjustment for altitude.

This tool is intended for patients with low risk for PE and who live at high altitude (>4000 ft). 

High altitude (>4000 ft)
Age ≥50
HR ≥100
Unilateral leg swelling
Hemoptysis
Recent surgery or trauma
Surgery or trauma ≤4 weeks ago requiring treatment with general anesthesia
Prior PE or DVT
Hormone use
Oral contraceptives, hormone replacement or estrogenic hormones use in males or female patients

Result:

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Management

  • If your patient is low risk for PE and PERC-Altitude negative, then you can rule out PE without further testing.

  • If your patient is PERC-Altitude positive, further testing (D-dimer or CTPA) is required to rule out PE.

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