MedCourseFinder

Haematology

Wells Score for Deep Vein Thrombosis

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Formula

Modified Wells (2003): +1 for each of nine findings, -2 if an alternative diagnosis is at least as likely. Three-tier: 0 or below low, 1-2 moderate, 3 or above high. Two-tier: 2 or above likely.

Limitations

  • The "previously documented DVT" item belongs to the 2003 modified score; the 1997 original has different items.
  • Not validated in every setting for patients whose symptoms are confounded by a previous DVT; combine with D-dimer or ultrasound according to the local pathway.
  • Versions differ on the surgery window of the bedridden/major surgery item: this tool uses 12 weeks (major surgery requiring general or regional anaesthesia), as in several published tables of the modified score, whereas other descriptions give 4 weeks.

References

  1. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Wells PS, Anderson DR, Bormanis J, et al. Lancet. 1997;350(9094):1795-1798. PMID 9428249
  2. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis (modified Wells score). Wells PS, Anderson DR, Rodger M, et al. N Engl J Med. 2003;349(13):1227-1235. PMID 14507948