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Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis |
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Written by G. Firman MD
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Sunday, 08 March 2009 09:39 |
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Wells Clinical Prediction Rule for Pulmonary Embolism (PE)
| Clinical feature | Points | | Clinical symptoms of DVT | 3 | | Other diagnosis less likely than PE | 3 | | Heart rate greater than 100 beats per minute | 1.5 | | Immobilization or surgery within past 4 weeks | 1.5 | | Previous DVT or PE | 1.5 | | Hemoptysis | 1 | | Malignancy | 1 | | Total points | | PE = pulmonary embolism; DVT = deep venous thrombosis. Risk score interpretation (probability of PE): -
>6 points: high risk (78.4%); -
2 to 6 points: moderate risk (27.8%); -
<2 points: low risk (3.4%)
Wells Clinical Prediction Rule for Deep Venous Thrombosis (DVT) | Clinical feature | Points | | Active cancer (treatment within 6 months, or palliation) | 1 | | Paralysis, paresis, or immobilization of lower extremity | 1 | | Bedridden for more than 3 days because of surgery (within 4 weeks) | 1 | | Localized tenderness along distribution of deep veins | 1 | | Entire leg swollen | 1 | | Unilateral calf swelling of greater than 3 cm (below tibial tuberosity) | 1 | | Unilateral pitting edema | 1 | | Collateral superficial veins | 1 | | Alternative diagnosis as likely as or more likely than DVT | -2 | | Total points | | DVT = deep venous thrombosis. Risk score interpretation (probability of DVT): References: -
Wells PS, Anderson DR, Rodger M, Ginsberg JS, Kearon C, Gent M, Turpie AG, Bormanis J, Weitz J, Chamberlain M, Bowie D, Barnes D, Hirsh J. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000 Mar;83(3):416-20. [Medline] -
Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Gray L, Clement C, Robinson KS, Lewandowski B. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997 Dec 20-27;350(9094):1795-8. [Medline]
Created: April 13, 2006
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Last Updated on Friday, 30 December 2011 03:46 |
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