Wells score

Wells Score is a clinical prediction rule used in the diagnosis of pulmonary embolism (PE). It was developed by Dr. Philip Wells and his team in 1998. The Wells Score is a tool that helps physicians determine the likelihood of PE in a patient based on clinical signs and symptoms.

Overview

The Wells Score is a scoring system that assigns points to various clinical features and risk factors associated with PE. The total score is then used to categorize patients into different risk groups: low, moderate, or high risk. The higher the score, the greater the likelihood of PE.

Scoring System

The Wells Score includes seven criteria, each assigned a certain number of points:

• Clinical signs and symptoms of deep vein thrombosis (DVT) (3 points)
• An alternative diagnosis is less likely than PE (3 points)
• Heart rate over 100 beats per minute (1.5 points)
• Immobilization or surgery in the previous four weeks (1.5 points)
• Previous objectively diagnosed PE or DVT (1.5 points)
• Hemoptysis (1 point)
• Malignancy (1 point)

The total score can range from 0 to 12.5. A score of less than 2 indicates a low probability of PE, a score of 2 to 6 indicates a moderate probability, and a score greater than 6 indicates a high probability.

Clinical Use

The Wells Score is used in conjunction with diagnostic testing, such as D-dimer testing and computed tomography pulmonary angiography (CTPA), to diagnose PE. It helps physicians decide which patients require further testing and which can be safely discharged without further workup.

Limitations

While the Wells Score is a useful tool, it has some limitations. It is not 100% accurate and should not be used in isolation to rule in or rule out PE. It should always be used in conjunction with other diagnostic tests and clinical judgment.

See Also

• Pulmonary embolism
• Deep vein thrombosis
• D-dimer
• Computed tomography pulmonary angiography