PERC Rule (PE rule-out)

PERC rule (Kline 2004): eight rule-out criteria (age >= 50, HR >= 100, SaO2 < 95%, hemoptysis, estrogen, prior VTE, recent surgery/trauma, unilateral leg swelling).

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Age >= 50
Yes

Result: PERC 1 positive feature (age >= 50): rule-out does NOT apply.

The tool opens with these values already filled in. Replace them with your own.

What the result means

0 features positive
PERC negative. In patients with low pretest probability, PE can be excluded without further testing per source.
>=1 feature positive
PERC positive. Rule-out does not apply; further evaluation per source.

What you enter

  • Age >= 50
  • HR >= 100
  • SaO2 < 95%
  • Hemoptysis
  • Estrogen use
  • Prior VTE
  • Recent surgery or trauma
  • Unilateral leg swelling

What this is

Check the eight-item Pulmonary Embolism Rule-out Criteria (Kline 2004): age <50, HR <100, SpO2 >=95% on room air, no hemoptysis, no exogenous estrogen, no prior DVT/PE, no recent surgery or trauma, and no unilateral leg swelling. If every criterion is satisfied in a patient who is already low pretest probability, PE can be ruled out without further workup.

When to use it

Apply PERC only after clinical gestalt or Wells has already established a low pretest probability for PE. PERC is a rule-out aid for that specific population - it is not a screening test, and a single failed criterion does not diagnose PE; it only means PERC cannot be used and the workup continues with D-dimer or imaging.

How this is calculated

Kline JA, et al. PERC rule. J Thromb Haemost. 2004;2(8):1247-1255. Use only if clinical pretest probability is low. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.