Wells criteria: Difference between revisions
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==See Also== | ==See Also== | ||
*[[EBQ:Wells PE Rule Out]] | *[[EBQ:Wells PE Rule Out]] | ||
*[[PE]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references> | <references> | ||
[[Category:Cards]] [[Category:Pulm]] [[Category:Vascular]] |
Revision as of 20:49, 20 October 2015
Background
Criteria and Score
Wells Criteria
Clinical Features | Points |
---|---|
Symptoms of DVT (leg swelling and pain with palpation) | 3.0 |
PE as likely as or more likely than an alternative diagnosis | 3.0 |
HR >100 bpm | 1.5 |
Immobilization for >3 consecutive days or surgery in the previous 4 weeks | 1.5 |
Previous DVT or PE | 1.5 |
Hemoptysis | 1.0 |
Malignancy (receiving treatment, treatment stopped within 6 mon, palliative care) | 1.0 |
Two Tier Wells Score
- Score 0-4 = PE Unlikely (12.1% incidence of PE)
- Check D-dimer
- If D-dimer positive then obtain CTPA or V/Q scan
- If D-dimer negative, no further workup needed (0.5% incidence of PE at 3 month follow up)
- Check D-dimer
- Score >4 = PE Likely (37.1% incidence of PE)
- Obtain CT Pulmonary Angiography or V/Q Scan
- New evidence suggests lower Wells Score with D-dimer <1000 ng/mL is effective at ruling out PE without imaging
See Also
External Links
References
<references>