Wells score in the clinical prediction of pulmonary embolus (PE)
Last reviewed 01/2021
Wells et al developed a simple clinical model which was able to predict the possibility of a patient having a PE.
It contained 7 variables with a total score of 12.5 points
- predisposing factors
- previous DVT or PE - 1.5 points
- recent surgery or immobilization - 1.5 points
- cancer - 1 point
- symptoms
- haemoptysis - 1 point
- clinical signs
- heart rate >100 beats/min - 1.5 points
- clinical signs of DVT - 3 points
- clinical judgement
- alternative diagnosis less likely than PE - 3 points
The clinical probability can be divided according to the points scored into:
- three-category scheme
- low 0-1 points
- intermediate 2-6 points
- high 7 or more points
- two-category scheme
- PE unlikely 0-4 points
- PE likely >4 points
The two category (two level) Well's score is used by NICE (2).
Reference:
- 1. Torbicki A et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J. 2008;29(18):2276-315.
- 2. NICE (June 2012). Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing
assessment of clinical probability of pulmonary embolism (PE)