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The Wells score may refer to one of two clinical prediction rules in clinical medicine: Wells score for deep vein thrombosis Wells' score for pulmonary embolism
Wells score for PE [3] Variable Points Clinical signs and symptoms of DVT 3 An alternate diagnosis is less likely than PE 3 Heart rate >100 1.5 Immobilization or surgery in the previous 4 weeks 1.5 Previous DVT / PE 1.5 Hemoptysis 1 Malignancy (treatment currently, in the previous 6 months, or palliative) 1
The risk of deep vein thrombosis can be estimated by Wells score. Lower limbs venous ultrasonography is also indicated in cases of suspected pulmonary embolism where a CT pulmonary angiogram is negative but a high clinical suspicion of pulmonary embolism remains. [1] It may identify a deep vein thrombosis in up to 50% of people with pulmonary ...
A new prediction score for PE was created in 1998 [40] This prediction rule was revised by Wells et al. in 2000. [41] In the 2000 publication, Wells proposed two different scoring systems using cutoffs of 2 or 4 with the same prediction rule, and also included D-dimer testing in the rule-out of PE in low probability patients. [41]
Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. [9] [a] A minority of DVTs occur in the arms. [11] Symptoms can include pain, swelling, redness, and enlarged veins in the affected area, but some DVTs have no symptoms. [1]
Deep vein thrombosis may require thrombolysis if there is a significant risk of post-thrombotic syndrome. [42] Thrombolysis may be administered by intravenous catheter directly into the clot ("catheter-directed thrombolysis"); this requires a lower dose of the medication and may carry a lower bleeding risk but evidence for its benefit is limited.
An elevated D-dimer in the elderly population has no predictive value for deep venous thrombosis. Signs and symptoms of DVT in general are not sufficiently sensitive or specific to make a diagnosis, being helpful only to help determine the likelihood of a DVT (with the use of a clinical prediction rule such as the Wells score). [5]
Philip Steven Wells is a Canadian hematologist and current chair and Chief of Medicine at the University of Ottawa and The Ottawa Hospital. [1] He is considered an expert in thromboembolic disorders and is known for developing the Wells risk score for pulmonary embolism and deep vein thrombosis .