What Wells PE score thresholds guide CT decision?

Two-level: Wells ≤4 = low probability (PE ruled out if D-dimer 4 = PE likely (CTPA required). Three-level: 0-1 = low; 2-6 = moderate; ≥7 = high; YEARS algorithm additionally uses clinical gestalt and DVT signs.

What is the PERC rule for PE exclusion?

PERC rule: if ALL 8 criteria absent (age <50, HR <100, SpO2 ≥95%, no leg swelling, no hemoptysis, no recent trauma/surgery, no prior PE/DVT, no estrogen use) AND Wells <2 = PE can be ruled out without D-dimer.

What thrombolysis threshold exists for massive PE?

Massive PE (hemodynamic instability: SBP <90 or circulatory collapse): systemic thrombolysis alteplase 100 mg over 2h (weight-based 0.6 mg/kg, max 50 mg for submassive); CDT or surgical embolectomy for thrombolysis failure or contraindication.

What is the submassive PE treatment decision?

Submassive PE (RV dysfunction on echo + troponin elevation without haemodynamic compromise): anticoagulation with monitoring; thrombolysis reserved for haemodynamic deterioration; catheter-directed thrombolysis (CDT) for intermediate-high risk PE.

What PESI score stratifies PE prognosis?

Simplified PESI: 1 point each for age >80, cancer, chronic cardiopulmonary disease, HR ≥110, SBP <100, SpO2 <90%; PESI 0 = low risk (30-day mortality <1%); PESI ≥1 = high risk; low PESI allows outpatient PE treatment with DOAC in selected patients.

Wells Score for Pulmonary Embolism Probability

Calculates the Wells clinical prediction score for PE probability, integrates with D-dimer (PERC, YEARS algorithm) to stratify patients for CTPA need, and guides anticoagulation vs thrombolysis vs CDT threshold.

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Frequently Asked Questions

What Wells PE score thresholds guide CT decision?

What is the PERC rule for PE exclusion?

What thrombolysis threshold exists for massive PE?

What is the submassive PE treatment decision?

What PESI score stratifies PE prognosis?