{"id":2493,"date":"2009-03-08T17:39:27","date_gmt":"2009-03-08T17:39:27","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/hemwells\/"},"modified":"2025-05-14T19:09:56","modified_gmt":"2025-05-14T19:09:56","slug":"hemwells","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/hemwells\/","title":{"rendered":"Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT).<!--more--><\/p>\n<p class=\"MsoNormal\"><strong>Wells Clinical Prediction Rule for Pulmonary Embolism (PE)<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><strong>Clinical feature<\/strong><\/td>\n<td style=\"text-align: center;\"><strong>Points<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Clinical symptoms of DVT<\/td>\n<td style=\"text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td>Other diagnosis less likely than PE<\/td>\n<td style=\"text-align: center;\">3<\/td>\n<\/tr>\n<tr>\n<td>Heart rate greater than 100 beats per minute<\/td>\n<td style=\"text-align: center;\">1.5<\/td>\n<\/tr>\n<tr>\n<td>Immobilization or surgery within past 4 weeks<\/td>\n<td style=\"text-align: center;\">1.5<\/td>\n<\/tr>\n<tr>\n<td>Previous DVT or PE<\/td>\n<td style=\"text-align: center;\">1.5<\/td>\n<\/tr>\n<tr>\n<td>Hemoptysis<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Malignancy<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td><strong><em>Total points<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">PE = pulmonary embolism; DVT = deep venous thrombosis.<\/p>\n<p class=\"MsoNormal\">Risk score interpretation (probability of PE):<\/p>\n<ul>\n<li class=\"MsoNormal\">&gt;6 points: high risk (78.4%);<\/li>\n<li class=\"MsoNormal\">2 to 6 points: moderate risk (27.8%);<\/li>\n<li class=\"MsoNormal\">&lt;2 points: low risk (3.4%)<\/li>\n<\/ul>\n<p class=\"MsoNormal\"><strong> Wells Clinical Prediction Rule for Deep Venous Thrombosis (DVT)<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td><strong>Clinical feature<\/strong><\/td>\n<td style=\"text-align: center;\"><strong>Points<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Active cancer (treatment within 6 months, or palliation)<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Paralysis, paresis, or immobilization of lower extremity<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Bedridden for more than 3 days because of surgery (within 4 weeks)<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Localized tenderness along distribution of deep veins<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Entire leg swollen<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Unilateral calf swelling of greater than 3 cm (below tibial tuberosity)<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Unilateral pitting oedema<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Collateral superficial veins<\/td>\n<td style=\"text-align: center;\">1<\/td>\n<\/tr>\n<tr>\n<td>Alternative diagnosis as likely as or more likely than DVT<\/td>\n<td style=\"text-align: center;\">-2<\/td>\n<\/tr>\n<tr>\n<td><strong><em>Total points<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">DVT = deep venous thrombosis.<\/p>\n<p class=\"MsoNormal\">Risk score interpretation (probability of DVT):<\/p>\n<ul>\n<li class=\"MsoNormal\">&gt;\/=3 points: high risk (75%);<\/li>\n<li class=\"MsoNormal\">1 to 2 points: moderate risk (17%);<\/li>\n<li class=\"MsoNormal\">&lt;1 point: low risk (3%).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>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.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10744147\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>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.\u00a01997 Dec 20-27;350(9094):1795-8.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9428249\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: April 13, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[171],"tags":[1348,812,490,1508,27,28,1381,429,428,1507,234,29,1500,1501,1502,1503,1504,1505,1506,899,1509],"class_list":["post-2493","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-cardiology","tag-clinica","tag-clinical","tag-deep","tag-embolism","tag-embolismo","tag-hematology","tag-prediccion","tag-prediction","tag-profunda","tag-pulmonar","tag-pulmonary","tag-regla","tag-rule","tag-thrombosis","tag-tromboembolismo","tag-trombosis","tag-tvp","tag-venosa","tag-venous","tag-wells"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2493"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2493\/revisions"}],"predecessor-version":[{"id":8832,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2493\/revisions\/8832"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2493"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}