Template:Modified Wells Score: Difference between revisions
Ostermayer (talk | contribs) No edit summary |
Ostermayer (talk | contribs) (Text replacement - " DVT " to " DVT") |
||
| Line 1: | Line 1: | ||
''Can be applied for patients who's clinical presentation is concerning for a DVT in order to risk stratify.'' | ''Can be applied for patients who's clinical presentation is concerning for a [[DVT]]in order to risk stratify.'' | ||
*Active cancer (<6 mo) - 1pt | *Active cancer (<6 mo) - 1pt | ||
*Paralysis, paresis, or immob of extremity - 1pt | *Paralysis, paresis, or immob of extremity - 1pt | ||
| Line 12: | Line 12: | ||
'''[[Modified Wells Score|Scoring]]: ''' | '''[[Modified Wells Score|Scoring]]: ''' | ||
A '''score of 0 or lower''' is associated with DVT unlikely with a prevalence of DVT of 5%. D-dimer testing is safe in this group and will decrease the probability of disease to <1 % allowing an [[DVT ultrasound|ultrasound]] to be deferred. '''A score of 1-2''' is considered moderate risk (17%) for DVT but can still proceed with testing using a high sensitivity D-dimer to decrease the post test probability of a [[DVT]] to <1% if negative but require [[DVT ultrasound|ultrasound]] if positive. '''A score of 3 or higher''' suggests DVT is likely (17-53%) and patients should receive an [[DVT ultrasound|ultrasound]] but also send a [[d-dimer]] because if the [[D-dimer]] is positive and the ultrasound is negative, the patient should receive a followup ultrasound in 2 weeks.<ref>Del Rios M et al. Focus on: Emergency Ultrasound For Deep Vein Thrombosis. ACEP News. March 2009. https://www.acep.org/clinical---practice-management/focus-on--emergency-ultrasound-for-deep-vein-thrombosis/.</ref> | A '''score of 0 or lower''' is associated with [[DVT]]unlikely with a prevalence of [[DVT]]of 5%. D-dimer testing is safe in this group and will decrease the probability of disease to <1 % allowing an [[DVT ultrasound|ultrasound]] to be deferred. '''A score of 1-2''' is considered moderate risk (17%) for [[DVT]]but can still proceed with testing using a high sensitivity D-dimer to decrease the post test probability of a [[DVT]] to <1% if negative but require [[DVT ultrasound|ultrasound]] if positive. '''A score of 3 or higher''' suggests [[DVT]]is likely (17-53%) and patients should receive an [[DVT ultrasound|ultrasound]] but also send a [[d-dimer]] because if the [[D-dimer]] is positive and the ultrasound is negative, the patient should receive a followup ultrasound in 2 weeks.<ref>Del Rios M et al. Focus on: Emergency Ultrasound For Deep Vein Thrombosis. ACEP News. March 2009. https://www.acep.org/clinical---practice-management/focus-on--emergency-ultrasound-for-deep-vein-thrombosis/.</ref> | ||
Revision as of 16:43, 27 January 2017
Can be applied for patients who's clinical presentation is concerning for a DVTin order to risk stratify.
- Active cancer (<6 mo) - 1pt
- Paralysis, paresis, or immob of extremity - 1pt
- Bedridden >3 d b/c of symptoms (within 4 wk) - 1pt
- TTP along deep venous system - 1pt
- Entire leg swollen - 1pt
- Unilateral calf swelling >3cm below tibial tuberosity - 1pt
- Unilateral pitting edema - 1pt
- Collateral superficial veins (not varicose) - 1pt
- Previously documented DVT - 1pt
- Alternative diagnosis as likely or more likely than DVT - (-)2pts
Scoring: A score of 0 or lower is associated with DVTunlikely with a prevalence of DVTof 5%. D-dimer testing is safe in this group and will decrease the probability of disease to <1 % allowing an ultrasound to be deferred. A score of 1-2 is considered moderate risk (17%) for DVTbut can still proceed with testing using a high sensitivity D-dimer to decrease the post test probability of a DVT to <1% if negative but require ultrasound if positive. A score of 3 or higher suggests DVTis likely (17-53%) and patients should receive an ultrasound but also send a d-dimer because if the D-dimer is positive and the ultrasound is negative, the patient should receive a followup ultrasound in 2 weeks.[1]
- ↑ Del Rios M et al. Focus on: Emergency Ultrasound For Deep Vein Thrombosis. ACEP News. March 2009. https://www.acep.org/clinical---practice-management/focus-on--emergency-ultrasound-for-deep-vein-thrombosis/.