Pulmonary Embolus – Wells’ Criteria for Pulmonary Embolus

Decision

Calculates Well’s risk score for Pulmonary Embolus

Population

Clinic and Hospital

Components

  • Clinical Signs and Symptoms of DVT?  Yes    +3
  • PE Is Most Likely Diagnosis or Equally Likely  Yes    +3
  • Heart Rate > 100?  Yes    +1.5
  • Immobilization at least 3 days, or Surgery in the Previous 4 weeks  Yes    +1.5
  • Previous, objectively diagnosed PE or DVT?  Yes   +1.5
  • Hemoptysis?  Yes   +1
  • Malignancy w/ Treatment within 6 mo, or palliative?  Yes    +1
  • Patient has none of these  Yes     0

Score

High risk group: 40.6% chance of PE in an ED population.Another study assigned scores > 4 as ‘PE Likely’ and had a 28% incidence of PE.

Moderate risk group: 16.2% chance of PE in an ED population. Another study assigned scores > 4 as ‘PE Likely’ and had a 28% incidence of PE.

Low risk group: 1.3% chance of PE in an ED population.Another study assigned scores ≤ 4 as ‘PE Unlikely’ and had a 3% incidence of PE.

Reference

Wells PS, Anderson DR, Rodger M, Stiell I, Dreyer JF, Barnes D, Forgie M, Kovacs G, Ward J, Kovacs MJ. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med. 2001 Jul 17;135(2):98-107. PubMed PMID: 11453709.

Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM. Prospective validation of Wells Criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med. 2004 Nov;44(5):503-10. PubMed PMID: 15520710.