Looking for more details? Read our comprehensive Wells Score for PE guide
What is the Wells Score for PE?
The Wells Score for Pulmonary Embolism (PE) is a clinical prediction rule that helps clinicians estimate the pre-test probability of a PE in patients presenting with symptoms suggestive of the condition. It guides further diagnostic testing such as D-dimer and imaging.
Scoring Interpretation
The score can be interpreted using either a two-tier or three-tier model, though the two-tier model is often preferred when used in conjunction with D-dimer testing.
Two-Tier Model (Recommended)
- > 4 Points: PE Likely
- ≤ 4 Points: PE Unlikely
Three-Tier Model (Traditional)
- > 6 Points: High risk (Probability ~59%)
- 2.0 - 6.0 Points: Moderate risk (Probability ~16%)
- < 2.0 Points: Low risk (Probability ~1.3%)
How to Use
Select the clinical findings that match the patient's presentation. The total score will stratify the patient's risk of Pulmonary Embolism.
Case Example
Patient: Presenting with tachycardia (HR 110), hemoptysis, and PE is the most likely diagnosis.
Calculation: HR>100 (1.5) + Hemoptysis (1.0) + Alternative less likely (3.0) = 5.5.
Interpretation: Moderate probability of PE. Further diagnostic testing (like D-dimer or CTA) is indicated.
Frequently Asked Questions
The Pulmonary Embolism Rule-out Criteria (PERC) rule can only be applied to patients who have a LOW clinical probability of PE (e.g., Wells score < 2). If PERC is negative, PE is practically ruled out.