Risk Scores

Question 1

What questions are asked for an adapted Well’s score for PE?

7 Points (6 Qs)

Answer 1

1. Clinical s+s of DVT(3)
2. PE most likely diagnosis (3)
3. Tachycardia (>100bpm) (1.5)
4. Immobilisation or surgery in past 4 weeks (1.5)
5. Prev DVT/PE (1.5)
6. Haemoptysis (1)
7. Malignancy/Treated in past 6M (1)

> 4 PE is likely
< PE is unlikely

Question 2

What questions would you ask for Wells Score (DVT)?

9 Points (8 Qs)

Answer 2

1. Active cancer (treatment within last 6 months or palliative) [1]
2. Paralysis, paresis, or recent plaster immobilisation of leg [1]
3. Major surgery or recently bedridden for >3 days in last 4 weeks [1]
4. Local tenderness along distribution of deep venous system [1]
5. Entire leg swollen [1]
6. Calf swelling >3cm compared to asymptomatic leg (measured 10cm below the tibial tuberosity) [1]
7. Pitting oedema [1]
8. Collateral superficial veins (non-varicose) [1]
9. D.dx more likely than DVT (-2)

> 3 - High risk DVT/Compression US

1-2 = Med-Risk
Suspected DVT + perform compression US

0 = Low risk
D-dimer + [Treat as suspected DVT and compression US]