Wells criteria for pulmonary embolism
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The Wells' criteria for pulmonary embolismis a risk stratification score to estimate the probability for pulmonary embolism (PE) in patients in which history and examination suggests PE is a diagnostic possibility. It provides a pre-test probability which, if deemed unlikely, can then be used in conjunction with a negative D-dimer to rule out PE avoiding imaging1.
Criteria
- clinical signs and symptoms of DVT = 3
- PE is most likely diagnosis or equally likely = 3
- heart rate more than 100 = 1.5
- iImmobilisation for 3 or more consecutive days or surgery in the previous 4 weeks = 1.5
- previous objectively diagnosed PE or DVT = 1.5
- haemoptysis = 1
- malignancy (had treatment in the last 6 months or palliative) = 1
Score interpretation
Can be applied in either three tier or two tier models:
Three tier:
- 0-1: low risk
- 2-6: moderate risk
- >6: high risk
Two tier:
- ≤4: unlikely
- ≥5: likely
In the three tier model:
- low risk patients: pulmonary embolism rule-out criteria (PERC) can be considered as well as D-dimer
- moderate risk: consider D-dimer or CT pulmonary angiography
- high risk: D-dimer not recommended
.
In the two tier model:
- unlikely: consider D-dimer
- likely: consider CTPA
-<p>The <strong>Wells' criteria for pulmonary embolism</strong><strong> </strong>is a risk stratification score to estimate the probability for <a href="/articles/pulmonary-embolism">pulmonary embolism</a> (PE) in patients in which history and examination suggests PE is a diagnostic possibility. It provides a pre-test probability which, if deemed unlikely, can then be used in conjunction with a negative <a href="/articles/d-dimer">D-dimer</a> to rule out PE avoiding imaging<sup>1</sup>.</p><h4>Criteria</h4><ul>- +<p>The <strong>Wells' criteria for pulmonary embolism</strong><strong> </strong>is a risk stratification score to estimate the probability for <a href="/articles/pulmonary-embolism">pulmonary embolism</a> (PE) in patients in which history and examination suggests PE is a diagnostic possibility. It provides a pre-test probability which, if deemed unlikely, can then be used in conjunction with a negative <a href="/articles/d-dimer">D-dimer</a> to rule out PE avoiding imaging <sup>1</sup>.</p><h4>Criteria</h4><ul>
-<li>high risk: D-dimer not recommended.</li>- +<li>high risk: D-dimer not recommended</li>
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