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Wells score http://handbook.muh.ie/Haematology/Wells.html

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Home - Ematology - Wells score

WELLS CRITERIA /SCORING FOR DVTPRESENT SCORE

Lower limb trauma or surgery or immobilisation in a plaster cast +1

Bedridden for more than three days or surgery within the last fourweek +1

Tenderness along line of femoral or popliteal veins (NOT just calftenderness) +1

Entire limb swollen +1

Calf more than 3cm bigger circumference,10cm below tibialtuberosity +1

Pitting oedema +1

Dilated collateral superficial veins (non-varicose) +1

Past Hx of confirmed DVT +1

Malignancy (including treatment up to six months previously) +1

Intravenous drug use +3

Alternative diagnosis as more likely than DVT -2

Pre-test Clinical probability of a DVT with score:

DVT "Likely" if Well's > 1DVT "Unlikely" if Wells< 2

WELLS CRITERIA / SCORING FOR PEPRESENT SCORE

Clinical Signs and Symptoms of DVT? +3

PE is No. 1 Dx or Equally likley Dx +3

Heart Rate > 100 +1.5

Immobilization at least 3 days, or Surgery in the Previous 4 weeks +1.5

5 Previous, objectively diagnosed PE or DVT? +1.5

Haemoptysis? +1

Malignancy with treatment within 6 months, or palliative? +1

Wells score http://handbook.muh.ie/Haematology/Wells.html

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Pre-test clinical probability of a PE:

Wells Score > 4 - PE likely. Consider diagnostic imaging.Wells Score 4 or less - PE unlikely. Consider D-dimer torule out PE.

2003 BTS Guidelines - a practical approach to ? PE (not using the Wells criteria) areavailable in the PE page

REFERENCES

Wells PS, Owen C, Doucette S, Fergusson D, Tran H. Does this patient have deep veinthrombosis? JAMA. 2006 Jan 11;295(2):199-207.

Scarvelis D, Wells PS. Diagnosis and treatment of deep-vein thrombosis. CMAJ. 2006 Oct24;175(9):1087-92. Review. Erratum in: CMAJ. 2007 Nov 20;177(11):1392.

Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, Kovacs G, Mitchell M,Lewandowski B, Kovacs MJ. Evaluation of D-dimer in the diagnosis of suspected deep-veinthrombosis. N Engl J Med. 2003 Sep 25;349(13):1227-35.

Derivation of a simple clinical model to categorize patients probability of pulmonaryembolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000Mar;83(3):416-20.

Writing Group for the Christopher Study Investigators. Effectiveness of Managing SuspectedPulmonary Embolism Using an Algorithm Combining Clinical Probability, D-Dimer Testing, andComputed Tomography. JAMA. 2006;295:172-179.

Content by Dr Íomhar O' Sullivan 30/07/2007. Last revciewed Dr ÍOS 4/08/10

Comments to : Dr Íomhar O' Sullivan© Cork Emergency Medicine 2012. All rights reserved. Contact us Links

Wells score http://handbook.muh.ie/Haematology/Wells.html

3 dari 3 10/2/2012 7:13 AM