Advertisement
100% x 90

Wells Score PE Calculator

Clinical probability assessment for pulmonary embolism

Wells Criteria Assessment

📋 Clinical Guidelines

  • • Use Wells Score for hemodynamically stable patients with suspected PE
  • • Score ≤4: Consider D-dimer testing first
  • • Score ≥5: Proceed directly to imaging (CTPA preferred)
  • • Always consider clinical context and institutional protocols

Select all criteria that apply to the patient. The Wells Score helps determine the clinical probability of pulmonary embolism and guides diagnostic management.

Wells Score Results

0
Wells Score
PE Unlikely
2-Level Classification
Low Risk
3-Level Classification

📊 Two-Level Classification (Recommended)

Category:PE Unlikely
Probability:~12% of patients have confirmed PE
Management:Measure D-dimer level. If negative, PE is excluded. If positive, proceed to imaging.

📈 Three-Level Classification (Alternative)

Category:Low Risk
Probability:~10% of patients have confirmed PE
Management:D-dimer testing recommended. Low likelihood of PE.

✅ Next Step: D-dimer Testing

Wells Score ≤4 suggests low clinical probability. Measure D-dimer level. If negative, PE is excluded. If positive, proceed to imaging studies.

Clinical Example

Case: 45-year-old Post-Surgical Patient

Presentation: Shortness of breath and chest pain 5 days after hip replacement surgery

Wells Score Assessment:

  • • DVT symptoms: No ❌ (0 points)
  • • Heart rate >100: Yes ✅ (1.5 points)
  • • Recent surgery: Yes ✅ (1.5 points)
  • • Previous VTE: No ❌ (0 points)
  • • Hemoptysis: No ❌ (0 points)
  • • Malignancy: No ❌ (0 points)
  • • PE likely: Yes ✅ (3 points)

Wells Score: 6 points (PE Likely - High Risk)

Management: Proceed directly to CTPA imaging

Advertisement
100% x 250

Wells Score Summary

Score 0-4: PE Unlikely

~12% PE probability - D-dimer first

Score ≥5: PE Likely

~50% PE probability - Direct imaging

Wells Criteria

DVT symptoms3.0
PE likely diagnosis3.0
Heart rate >1001.5
Immobilization/surgery1.5
Previous VTE1.5
Hemoptysis1.0
Malignancy1.0
Maximum Score12.5

🫁 PE Symptoms

Dyspnea (shortness of breath)
Pleuritic chest pain
Cough
Substernal chest pain
Hemoptysis
Syncope
Leg swelling (DVT)

📋 Diagnostic Algorithm

Step 1: Clinical Assessment

Calculate Wells Score for PE probability

Step 2: Score ≤4

Measure D-dimer level

Step 3: Score ≥5

Proceed to CTPA imaging

⚕️ Medical Disclaimer

This calculator is for educational purposes only and should not replace clinical judgment.

Wells Score should be used in conjunction with clinical assessment and institutional protocols.

Always consider the full clinical picture when making diagnostic and treatment decisions.

Understanding the Wells Score

What is the Wells Score?

The Wells Score is a validated clinical decision rule that estimates the probability of pulmonary embolism based on clinical findings and patient characteristics.

Clinical Implementation

  • Developed by Dr. Phil Wells in 2001
  • Bedside assessment tool for PE probability
  • Guides diagnostic strategy (D-dimer vs imaging)
  • Reduces unnecessary testing and radiation exposure

Evidence Base

Original Study (2001)

"Excluding pulmonary embolism at the bedside without diagnostic imaging" - Management strategy using clinical model and D-dimer

Validation Studies

Multiple prospective studies validating the Wells Score in different populations and healthcare settings

Clinical Performance

  • • High sensitivity for PE detection
  • • Effective risk stratification
  • • Reduces unnecessary imaging by ~30%
  • • Safe D-dimer exclusion strategy

Important Clinical Considerations

Patient Selection:

  • • Use in hemodynamically stable patients
  • • Suspected PE based on clinical presentation
  • • Not for massive PE or shock patients
  • • Consider pregnancy-specific algorithms

Score Interpretation:

  • • Two-level classification is preferred
  • • Combined with D-dimer for low probability
  • • Direct imaging for high probability
  • • Always consider clinical context
Advertisement
100% x 250