Parameters:
(1) age in years
(2) chronic respiratory disease
(3) heart rate in beats per minute
(4) chest pain and acute dyspnea
(5) sex
(6) hormonal estrogenic treatment
(7) personal history of venous thromboembolism (VTE)
(8) syncope
(9) immobility within the past 4 weeks (surgery, lower limb immobilization, bedridden for > 3 days)
(10) oxygen saturation on pulse oximetry in percent
(11) calf pain and/or unilateral lower limb edema
(12) pulmonary embolism is the most likely diagnosis
|
Parameter
|
Finding
|
Points
|
|
age
|
< 50 years
|
-2
|
|
|
50 to 64 years
|
-1
|
|
|
>= 65 years
|
0
|
|
chronic respiratory disease
|
no
|
0
|
|
|
yes
|
-1
|
|
heart rate
|
< 80 beats per minute
|
-1
|
|
|
>= 80 beats per minute
|
0
|
|
chest pain and dyspnea
|
no
|
0
|
|
|
yes
|
1
|
|
sex
|
female
|
0
|
|
|
male
|
2
|
|
estrogenic therapy
|
no
|
0
|
|
|
yes
|
2
|
|
history of VTE
|
no
|
0
|
|
|
yes
|
2
|
|
syncope
|
no
|
0
|
|
|
yes
|
2
|
|
immobility
|
no
|
0
|
|
|
yes
|
2
|
|
oxygen saturation
|
>= 95%
|
0
|
|
|
< 95%
|
3
|
|
calf pain or unilateral leg edema
|
no
|
0
|
|
|
yes
|
3
|
|
PE diagnosis
|
most likely diagnosis
|
5
|
|
|
not most likely diagnosis
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -4
• maximum score: 22
• The higher the score the greater the chance of a pulmonary embolus.
|
Score
|
Probability of PE
|
Pulmonary Embolism
|
|
< 0
|
very low (< 2%)
|
|
|
0 to 5
|
low (2 to 20%)
|
can rule out if D-dimer less than 1.0 µg/mL
|
|
6 to 12
|
moderate (20 to 65%)
|
can rule out if D dimer < 0.5 µg/mL (or if < 0.01 * age)
|
|
>= 13
|
high (> 65%)
|
cannot rule out without imaging studies
|
Performance:
• The area under the ROC curve is 0.79.
