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Age*
years
Sex*
Chronic respiratory disease*
Heart rate <80*
Chest pain AND acute dyspnea*
Current estrogen use*
Prior history of VTE*
Syncope*
Immobility within the last four weeks*
Surgery, lower limb plaster cast, or bedridden >3 days for acute medical condition within the last four weeks
O2 saturation <95%*
Calf pain and/or unilateral lower limb edema*
PE is the most likely diagnosis*
Fill out the fields above to see your result.
Rules out PE based on clinical criteria.
Addition of the selected points:
| Variable | Points | |
| Age, years | <50 | -2 |
| 50-64 | -1 | |
| >64 | 0 | |
| Sex | Female | 0 |
| Male | 2 | |
| Chronic respiratory disease | No | 0 |
| Yes | -1 | |
| Heart rate <80 | No | 0 |
| Yes | -1 | |
| Chest pain AND acute dyspnea | No | 0 |
| Yes | 1 | |
| Current estrogen use | No | 0 |
| Yes | 2 | |
| Prior history of VTE | No | 0 |
| Yes | 2 | |
| Syncope | No | 0 |
| Yes | 2 | |
| Immobility within the last four weeks* | No | 0 |
| Yes | 2 | |
| O2 saturation <95% | No | 0 |
| Yes | 3 | |
| Calf pain and/or unilateral lower limb edema | No | 0 |
| Yes | 3 | |
| PE is the most likely diagnosis | No | 0 |
| Yes | 5 | |
*Surgery, lower limb plaster cast, or bedridden >3 days for acute medical condition within the last four weeks.
Interpretation:
| 4PEPS Score for PE | Clinical probability of PE | PE diagnosis |
| <0 | Very low CPP (<2%) | PE can be ruled out |
| 0-5 | Low CPP (2-20%) | PE can be ruled out if D-dimer level <1.0 μg/mL |
| 6-12 | Moderate CPP (20-65%) | PE can be ruled out if D-dimer level <0.5 μg/mL OR <(age x 0.01) μg/mL |
| ≥13 | High CPP (>65%) | PE cannot be ruled out without imaging testing |
Do you use the 4-Level Pulmonary Embolism Clinical Probability Score (4PEPS) and want to contribute your expertise? Join our contributor team!
Do you use the 4-Level Pulmonary Embolism Clinical Probability Score (4PEPS) and want to contribute your expertise? Join our contributor team!