Wells Score for Deep Vein Thrombosis

Physicians are able to accurately stratify patients with suspected deep-vein thrombosis into three distinct pretest probabilities with the model.

Active cancer (treatment ongoing or within previous 6 months or palliative)
+1
Paralysis, paresis, or recent plaster immobilization of the lower extremities
+1
Recently bedridden longer than 3 days or major surgery within 4 weeks
+1
Localized tenderness along the distribution of the deep venous system
+1
Entire leg swollen
+1
Calf swelling by more than 3 cm when compared with asymptomatic leg (measured 10 cm below tibial tuberosity)
+1
Pitting edema (greater in the symptomatic leg)
+1
Collateral superficial veins (nonvaricose)
+1
Alternative diagnosis as likely or greater than that of deep-vein thrombosis
-2
Probability Of Having Deep Vein Thrombosis
0%
Based on a score of 0 out of 8
Recommendations:

Risk scores of < or equal to 0 make deep-vein thrombosis an unlikely diagnosis. Consider performing an ultrasound of the lower extremities.

  • If ultrasound is normal then deep-vein thrombosis is excluded.
  • If ultrasound is abnormal then perform a venography.

Risk scores of 1-2 can be suggestive of deep-vein thrombosis. Consider performing an ultrasound of the lower extremities.

  • If ultrasound is normal then repeat ultrasound in one week.
  • If ultrasound is abnormal then give anticoagulation therapy.

Risk scores of equal to or > 3 are very suggestive of deep-vein thrombosis. Consider performing an ultrasound of the lower extremities.

  • If ultrasound is normal then perform venography.
  • If ultrasound is abnormal then give anticoagulation therapy.