Template:Wells 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)
  • 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