Deep Vein Thrombosis – Wells’ criteria for DVT

Decision

Calculates Well’s risk score for DVT

Population

Clinic and Hospital

Components

Active cancer? Yes +1
Bedridden recently >3 days or major surgery within four weeks? Yes +1
Calf swelling >3cm compared to the other leg? Yes +1
Collateral (nonvaricose) superficial veins present? Yes +1
Entire leg swollen? Yes +1
Localized tenderness along the deep venous system? Yes +1
Pitting edema, greater in the symptomatic leg? Yes +1
Paralysis, paresis, or recent plaster immobilization of the lower extremity Yes +1
Previously documented DVT? Yes +1
Alternative diagnosis to DVT as likely or more likely? Yes -2
Patient has none of these Yes 0

Score

Score > or = 2 High risk group for DVT. “Likely” according to Wells DVT studies.

Score = 0-1 Low risk group for DVT. “Unlikely” according to Wells DVT studies.

Reference

Does this patient have deep vein thrombosis? Wells PS, Owen C, Doucette S, Fergusson D, Tran H. JAMA. 2006 Jan 11;295(2):199-207. Review.

Diagnosis and treatment of deep-vein thrombosis. Scarvelis D, Wells PS. CMAJ. 2006 Oct 24;175(9):1087-92. Review. Erratum in: CMAJ. 2007 Nov 20;177(11):1392.

Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, Kovacs G, Mitchell M, Lewandowski B, Kovacs MJ. N Engl J Med. 2003 Sep 25;349(13):1227-35.