Wells Score for PE

Clinical decision rule to estimate probability of pulmonary embolism and guide diagnostic testing.

Wells Criteria

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Wells Score

0 points

Recommended Workup

Score ≤ 4: PE Unlikely - Start with D-dimer

• D-dimer negative: PE ruled out. No imaging needed.
• D-dimer positive: Proceed to CT-PA
• Age-adjusted cutoff: Age × 10 for patients ≥50 years
• PERC Rule: Consider if very low suspicion

Score Interpretation

Score	Category	PE Prevalence	Next Step
0-4	PE Unlikely	~8%	D-dimer → If +, CT-PA
4.5-6	Moderate	~28%	CT-PA recommended
>6	High	~54%	CT-PA, consider empiric Rx

Reference: Wells PS, et al. Thromb Haemost 2000. Dichotomous interpretation (>4 = PE Likely).

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