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Wells Score (PE)
Pre-test probability of pulmonary embolism — guides D-dimer and imaging decisions
Emergency
⚕️
Clinical reference only. Not a substitute for professional medical judgment. Verify all results against institutional protocols before clinical use.
Calculate
Wells score guides pre-test probability only — not diagnostic. Clinical gestalt and D-dimer/imaging are required for diagnosis.
Formula
Wells PE = sum of 7 criteria (3 clinical signs, 4 risk/alternative diagnosis factors)
DVT signsClinical signs/symptoms of DVT (3 points)
Alt DxPE more likely than alternative diagnosis (3 points)
HRHeart rate > 100 bpm (1.5 points)
ImmobilityImmobilization ≥3 days or surgery in 4 weeks (1.5 points)
Prev PE/DVTPrevious DVT or PE (1.5 points)
HemoptysisHemoptysis (1 point)
MalignancyActive malignancy (1 point)
When to Use
Suspected pulmonary embolism — guides whether to order D-dimer vs proceed directly to CT-PA.
Clinical Pearls
- •Wells score ≤4 + negative high-sensitivity D-dimer safely excludes PE in most patients.
- •Revised Geneva score is an alternative that avoids subjective "PE more likely" criterion.
- •PERC rule can exclude PE without D-dimer in very low-risk patients (all 8 criteria negative).
- •Massive PE with hemodynamic instability — skip scoring, go directly to CT-PA or bedside echo.
Original Publication
Wells PS (2000). Thromb Haemost.