Wells Score for Pulmonary Embolism

The combination of a low score by the simple clinical prediction rule and a negative D-Dimer result may safely exclude pulmonary embolism in a large proportion of patients with suspected pulmonary embolism.

Clinical signs and symptoms of DVT (minimum of leg swelling and pain with palpation of the deep veins).
+3
An alternative diagnosis is less likely than PE
+3
Heart rate greater than 100
+1.5
Immobilization or surgery in the previous four weeks
+1.5
Previous DVT/PE
+1.5
Hemoptysis
+1
Malignancy (on treatment, treated in the last six months or palliative)
+1
Probability Of Pulmonary Embolism
0%
Based on a score of 0 out of 12.5
Recommendations:

Risk scores of <2 make pulmonary embolism an unlikely diagnosis. Consider performing a D-Dimer assay.

  • If D-Dimer assay is negative then pulmonary embolism is excluded.
  • If D-Dimer assay is positive then perform computed tomography (CT) angiography.

Risk scores of 2-6 can be suggestive of pulmonary embolism. Consider performing a D-Dimer assay.

  • If D-Dimer assay is negative then pulmonary embolism is excluded.
  • If D-Dimer assay is positive then perform computed tomography (CT) angiography.

Risk scores of >6 are very suggestive of pulmonary embolism. Consider performing a computed tomography (CT) angiography.