What is the Wells clinical decision rule for venous thromboembolism (VTE)?

Updated: Nov 05, 2020
  • Author: Vera A De Palo, MD, MBA, FCCP; Chief Editor: Vinod K Panchbhavi, MD, FACS  more...
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Answer

The likelihood of PE in a patient in whom it is suspected may be assessed by the Wells clinical decision rule. The criteria are scored as follows:

  • Clinical symptoms of DVT (3 points)
  • Other diagnoses less likely than PE (3 points)
  • Heart rate higher than 100 beats/min (1.5 points)
  • Immobilization for at least 3 days or surgery in previous 4 weeks (1.5 points)
  • Previous DVT/PE (1.5 points)
  • Hemoptysis (1 point)
  • Malignancy (1 point)

In the modified Wells criteria, PE is likely when the score is greater than 4 and unlikely when the score is less than 4. Highly sensitive D-dimer is coupled into the decision algorithm. [19]


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