Regla de predicción PERC y dímero D ajustado por Edad: Dos nuevas estrategias en el diagnóstico de Embolia pulmonar aguda

Pulmonary embolism is a high incidence disease despite underdiagnosis and carries a high risk of morbidity and mortality. The current pre-test tools (clinical, probability scales and D-dimer) have allowed to optimize the diagnostic accuracy, since it is problematic to select the subgroup of patients who will obtain a greater benefit from the practice of an angiotomography to establish the diagnosis of pulmonary embolism. This paper reviews critically the published evidence on the PERC scale and the adjusting of the D-dimer with age for the diagnosis of acute pulmonary embolism. As structured review of the medical literature on PubMed, Tripdatabase and Epistemonikos databases was made. Search was limited to meta-analysis, randomized studies, cohort studies, review articles and treatment guidelines without limits on language or date of publication, using MESH terms: D-dimer, pulmonary embolism, diagnosis. It was performed the reading of the title and abstract of 1512 references of which 50 were selected as representative for the subject of this review. We wrote the manuscript after classification and data extraction. The use of the PERC scale and age-adjusted D-dimer are recommended in the diagnostic approach of the patient with pulmonary embolism.