Clinical features

Clinical prediction rule to rank your patient's risk of a PE

Ask about a	Score
Haemoptysis	1.0
Previously objectively diagnosed deep vein thrombosis or pulmonary embolism	1.0
Malignancy (patients with cancer receiving treatment, or treatment stopped within previous 6 months, or receiving palliative care):	1.0
Immobilisation (bedrest, except access to bathroom, for 3 or more days; or surgery in previous 4 weeks	1.5

Look for a	Score
Heart rate > 100 beats/min	1.5
Clinical signs and symptoms of deep vein thrombosis (objectively measured leg swelling and pain with palpation in the deep-vein region)	3.0
Pulmonary embolism as likely or more likely than an alternative diagnosis (based on clinical information, chest X-ray, ECG and any blood tests required to diagnose PE):	3.0

Match your patient's score to the risk.

Score a	Risk of PE
> 6.0	High
2.0 to 6.0	Moderate
< 2.0	Low

Remember a PE cannot be safely diagnosed or excluded on history and physical examination alone. Further investigations are necessary. ^a  

• oral contraceptive pill use ^b  
• smoking ^a 
• hypertension ^a  
• obesity (body mass index > 29 kg/m²) ^a