The Cardiovascular
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Wells score for pulmonary embolism

Pre-test probability of pulmonary embolism.

Wells score for pulmonary embolism
Clinical signs of DVT
PE is the most likely diagnosis
Heart rate >100 /min
Immobilisation ≥3 days or surgery within 4 weeks
Previous PE or DVT
Haemoptysis
Malignancy (treated within 6 months or palliative)
Result0 points

PE unlikely — a negative D-dimer safely excludes PE.

Two-tier
PE unlikely
Three-tier probability
Low

When to use

  • Patients with suspected pulmonary embolism, to select those in whom D-dimer can safely exclude PE versus those needing imaging.

Formula

Signs of DVT (3) + PE most likely diagnosis (3) + HR >100 (1.5) + Immobilisation/surgery (1.5) + Previous PE/DVT (1.5) + Haemoptysis (1) + Malignancy (1). Maximum 12.5 points.

References

  1. Wells PS, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism. Thromb Haemost. 2000;83(3):416–20.