Template:Modified Wells Score: Difference between revisions
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===[[Modified Wells Score]]=== | |||
''Can be applied for patients whose clinical presentation is concerning for a [[DVT]] in order to risk stratify.'' | ''Can be applied for patients whose clinical presentation is concerning for a [[DVT]] in order to risk stratify.'' | ||
*Active cancer (<6 mo) | *Active cancer (<6 mo) (1pt) | ||
*Paralysis, paresis, or | *Paralysis, paresis, or immobility of extremity (1pt) | ||
*Bedridden >3 | *Bedridden >3 days because of symptoms within 4 weeks (1pt) | ||
*TTP along deep venous system | *TTP along deep venous system (1pt) | ||
*Entire leg swollen | *Entire leg swollen (1pt) | ||
*Unilateral calf swelling >3cm below tibial tuberosity | *Unilateral calf swelling >3cm below tibial tuberosity (1pt) | ||
*Unilateral pitting edema | *Unilateral pitting edema (1pt) | ||
*Collateral superficial veins | *Collateral superficial veins, not varicose (1pt) | ||
*Previously documented [[DVT]] | *Previously documented [[DVT]] (1pt) | ||
*Alternative diagnosis as likely or more likely than [[DVT]] | *Alternative diagnosis as likely or more likely than [[DVT]] (-2pts) | ||
'''[[Modified Wells Score|Scoring]]:''' | '''[[Modified Wells Score|Scoring]]:''' | ||
Latest revision as of 00:04, 27 November 2018
Modified Wells Score
Can be applied for patients whose clinical presentation is concerning for a DVT in order to risk stratify.
- Active cancer (<6 mo) (1pt)
- Paralysis, paresis, or immobility of extremity (1pt)
- Bedridden >3 days because of symptoms within 4 weeks (1pt)
- TTP along deep venous system (1pt)
- Entire leg swollen (1pt)
- Unilateral calf swelling >3cm below tibial tuberosity (1pt)
- Unilateral pitting edema (1pt)
- Collateral superficial veins, not varicose (1pt)
- Previously documented DVT (1pt)
- Alternative diagnosis as likely or more likely than DVT (-2pts)
- A score of 0 or lower → minimal risk - DVT prevalence of 5%. D-dimer testing is safe in this group - negative d-dimer decreases the probability of disease to <1% allowing an ultrasound to be deferred.
- A score of 1-2 → moderate risk - DVT prevalence of 17%. D-dimer testing still effective and a negative test decreases post-test probability disease to <1%
- A score of 3 or higher → high risk - DVT prevalence of 17-53% → patients should receive an ultrasound[1]
- ↑ Del Rios M et al. Focus on: Emergency Ultrasound For Deep Vein Thrombosis. ACEP News. March 2009. https://www.acep.org/clinical---practice-management/focus-on--emergency-ultrasound-for-deep-vein-thrombosis/