Wells score (pulmonary embolism)

Pre-test probability of PE

Wells score (pulmonary embolism)

Pre-test probability of PE

Clinical signs of DVT+3PE is the most likely diagnosis, or equally likely+3Heart rate > 100 /min+1.5Immobilisation ≥ 3 days or surgery in the past 4 weeks+1.5Previous DVT or PE+1.5Haemoptysis+1Active malignancy+1

0.0

0–4 — PE unlikely

Dichotomised rule: proceed to D-dimer; a negative D-dimer excludes PE.

Bands here use the dichotomised (unlikely / likely) rule. A three-tier version (< 2 low, 2–6 moderate, > 6 high) also exists — do not mix the two.

Source: Wells PS et al. Excluding pulmonary embolism at the bedside without diagnostic imaging. Ann Intern Med 2001;135(2):98-107.Open

Interpretation

0–4 — PE unlikely — Dichotomised rule: proceed to D-dimer; a negative D-dimer excludes PE.
> 4 — PE likely — Dichotomised rule: proceed directly to imaging (CTPA).

Bands here use the dichotomised (unlikely / likely) rule. A three-tier version (< 2 low, 2–6 moderate, > 6 high) also exists — do not mix the two.

Source: Wells PS et al. Excluding pulmonary embolism at the bedside without diagnostic imaging. Ann Intern Med 2001;135(2):98-107.

These tools do not replace clinical judgement. Interpret the result in the context of the whole patient.

Ask Medelix about the Wells score (pulmonary embolism)