Template:Modified Wells Score

Can be applied for patients who's clinical presentation is concerning for a DVT in 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 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 ultrasoundto 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 ultrasound if positive. A score of 3 or higher suggests DVT is 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