🫁 4PEPS Pulmonary Embolism Probability Score
UseWhen to use: hemodynamically stable suspected PE when choosing D-dimer vs imaging.
StrataVery low may rule out clinically; low uses 1000 ng/mL; moderate uses age-adjusted; high → imaging.
LimitsWhen not to use: unstable PE / shock — resuscitate and image. · Pitfall: mismatch of D-dimer units (FEU vs DDU). · Confirm assay-specific thresholds locally.
SourceRoy PM, et al. JAMA Cardiol 2021 (4PEPS)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Roy 2021 points.
When to use
When to use: hemodynamically stable suspected PE when choosing D-dimer vs imaging.
How it works
13 variables with points −2 to +5; bands <0 / 0–5 / 6–12 / ≥13.
Key points
- Roy 2021 points.
- 4 CPP bands.
- Next: YEARS / Wells PE / PERC / PESI.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 50–64 y (−1) |
|---|---|
| Sex | Female (0) |
| Chronic respiratory disease | No (0) |
| Heart rate < 80 bpm | No (0) |
| Chest pain AND acute dyspnea | No (0) |
| Current estrogen use | No (0) |
| Prior VTE | No (0) |
| Syncope | No (0) |
| Immobility within 4 weeks (surgery, cast, bedridden >3 d) | No (0) |
| O₂ saturation < 95% | No (0) |
| Calf pain and/or unilateral lower-limb edema | No (0) |
| PE is the most likely diagnosis | No (0) |
→4PEPS-1pts
- CPP band：Very low
- Next：Consider ruling out PE clinically without testing (strategy as published).
| Age | < 50 y (−2) |
|---|---|
| Sex | Female (0) |
| Chronic respiratory disease | No (0) |
| Heart rate < 80 bpm | No (0) |
| Chest pain AND acute dyspnea | No (0) |
| Current estrogen use | No (0) |
| Prior VTE | No (0) |
| Syncope | No (0) |
| Immobility within 4 weeks (surgery, cast, bedridden >3 d) | No (0) |
| O₂ saturation < 95% | No (0) |
| Calf pain and/or unilateral lower-limb edema | No (0) |
| PE is the most likely diagnosis | No (0) |
→4PEPS-2pts
- CPP band：Very low
- Next：Consider ruling out PE clinically without testing (strategy as published).
Verification & sources · governance
FAQ
Frequently asked questions
- Does 4PEPS Pulmonary Embolism Probability Score upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is 4PEPS Pulmonary Embolism Probability Score calculated in practice? Can you show a worked example?
- Inputs: Age 50–64 y (−1), Sex Female (0), Chronic respiratory disease No (0), Heart rate < 80 bpm No (0), Chest pain AND acute dyspnea No (0), Current estrogen use No (0), Prior VTE No (0), Syncope No (0)… → Result: 4PEPS -1 pts（CPP band: Very low, Next: Consider ruling out PE clinically without testing (strategy as published).） Inputs: Age < 50 y (−2), Sex Female (0), Chronic respiratory disease No (0), Heart rate < 80 bpm No (0), Chest pain AND acute dyspnea No (0), Current estrogen use No (0), Prior VTE No (0), Syncope No (0)… → Result: 4PEPS -2 pts（CPP band: Very low, Next: Consider ruling out PE clinically without testing (strategy as published).）