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    Wells' Criteria For DVT - MDCalc

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    Tepperoni
    This document provides details on Wells' Criteria for assessing the risk of deep vein thrombosis (DVT). It lists the criteria used to calculate a Wells' Score, provides guidance on risk stratification and clinical management based on the score. A high score indicates a patient is likely to have DVT while a low score means it is unlikely.

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    Wells' Criteria For DVT - MDCalc

    Uploaded by

    Tepperoni
    948 views4 pages
    This document provides details on Wells' Criteria for assessing the risk of deep vein thrombosis (DVT). It lists the criteria used to calculate a Wells' Score, provides guidance on risk stratification and clinical management based on the score. A high score indicates a patient is likely to have DVT while a low score means it is unlikely.

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    Info from MDCalc

    Original Title

    Wells' Criteria for DVT - MDCalc

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    This document provides details on Wells' Criteria for assessing the risk of deep vein thrombosis (DVT). It lists the criteria used to calculate a Wells' Score, provides guidance on risk stratification and clinical management based on the score. A high score indicates a patient is likely to have DVT while a low score means it is unlikely.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    948 views4 pages

    Wells' Criteria For DVT - MDCalc

    Uploaded by

    Tepperoni
    This document provides details on Wells' Criteria for assessing the risk of deep vein thrombosis (DVT). It lists the criteria used to calculate a Wells' Score, provides guidance on risk stratification and clinical management based on the score. A high score indicates a patient is likely to have DVT while a low score means it is unlikely.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Wells' Criteria for DVT - MDCalc 1/21/19, 1'22 PM

    Search “QT interval” or “QT” or “EKG” Log in SIGN UP (/SIGNUP)


    (/)

    Wells' Criteria for DVT About the Creator


    Calculates Wells' Score for risk of DVT.

    INSTRUCTIONS
    Dr. Phil Wells
    Note: The Wells' Score is less useful in hospitalized patients. (Silveira PC, 2015
    (http://www.ncbi.nlm.nih.gov/pubmed/25985219))

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    https://www.mdcalc.com/wells-criteria-dvt Page 1 of 4
    Wells' Criteria for DVT - MDCalc 1/21/19, 1'22 PM

    Pitting edema, confined to symptomatic leg No 0

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    No 0
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    0 points
    Low risk group for DVT. “Unlikely” according to Wells’ DVT studies.

    Copy Results # Next Steps

    ! Next Steps ! Evidence " Creator Insights

    ADVICE
    As with all clinical decision aids, the Wells’ DVT criteria is meant to aid clinical decision
    making and not force management.
    The Wells’ DVT criteria should only be applied after a detailed history and physical is
    performed.
    The Wells’ DVT criteria should only be applied to those patients who have been
    deemed at risk for DVT. If there is no concern for DVT than there is no need for risk
    stratification.

    MANAGEMENT
    Patients can be divided into “DVT unlikely” and “DVT likely” groups based on Wells score.
    An additional moderate risk group can be added based on the sensitivity of the d-dimer
    being used.

    https://www.mdcalc.com/wells-criteria-dvt Page 2 of 4
    Wells' Criteria for DVT - MDCalc 1/21/19, 1'22 PM

    A score of 0 or lower is associated with DVT unlikely with a prevalence of DVT of 5%.
    These patients should proceed to d-dimer testing:
    A negative high or moderate sensitivity d-dimer results in a probability <1 %
    and no further imaging is required.
    A positive d-dimer should proceed to US testing.
    A negative US is sufficient for DVT rule out.
    A positive US is concerning for DVT; strongly consider treatment with
    anticoagulation.

    A score of 1-2 is considered moderate risk with a pretest probability of 17%.*


    These patients should proceed to high-sensitivity d-dimer testing (moderate
    sensitivity d-dimer is not sufficient).
    A negative high-sensitivity d-dimer is sufficient for rule out of DVT in a
    moderate risk patient with a probability of <1%.
    A positive high sensitivity d-dimer should proceed to US testing.
    A negative US is sufficient for ruling out DVT.
    A positive US is concerning for DVT, strongly consider treatment with
    anticoagulation.

    A score of 3 or higher suggests DVT is likely. Pretest probability 17-53%.


    All DVT likely patients should receive a diagnostic US.
    D-dimer testing should be utilized to help risk-stratify these DVT-likely patients.
    In DVT likely patients with negative d-dimer:
    A negative US is sufficient for ruling out DVT, consider discharge.
    A positive US should be concerning for DVT, strongly consider treatment
    with anticoagulation.

    In DVT likely patients with a positive d-dimer:


    A positive US should be concerning for DVT, strongly consider treatment
    with anticoagulation.
    A negative US is still concerning for DVT. A repeat US should be performed
    within 1 week for re-evaluation.

    *Moderate risk group should only undergo d-dimer testing for rule out without
    ultrasonography if a high-sensitivity d-dimer is being used.

    CRITICAL ACTIONS
    No decision rule should trump clinical gestalt. High suspicion for DVT should warrant
    imaging regardless of Wells score.
    The Wells’ Criteria for DVT is utilized for the workup of DVT. The presence of DVT is
    critical to the evaluation of possible PE, and if PE is on the differential, alternative
    decision aids such as the Wells PE (https://www.mdcalc.com/wells-criteria-pulmonary-
    embolism) or PERC rule (https://www.mdcalc.com/perc-rule-pulmonary-embolism)
    should be entertained.

    Have feedback about this calculator? (/contact)

    https://www.mdcalc.com/wells-criteria-dvt Page 3 of 4
    Wells' Criteria for DVT - MDCalc 1/21/19, 1'22 PM

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