Diferencia entre revisiones de «Template:Wells Score»

Revisión actual - 16:48 29 nov 2019

Clinical Features	Points
Symptoms of DVT (leg swelling and pain with palpation)	3.0
PE as likely as or more likely than an alternative diagnosis	3.0
HR >100 bpm	1.5
Immobilization for >3 consecutive days or surgery in the previous 4 weeks	1.5
Previous DVT or PE	1.5
Hemoptysis	1.0
Malignancy (receiving treatment, treatment stopped within 6 mon, palliative care)	1.0

Score 0-4 = PE Unlikely (12.1% incidence of PE)
- Check D-dimer
  - If D-dimer positive then obtain CTPA or V/Q scan
  - If D-dimer negative, no further workup needed (0.5% incidence of PE at 3 month follow up)
Score >4 = PE Likely (37.1% incidence of PE)
- Obtain CT Pulmonary Angiography or V/Q Scan
New evidence suggests lower Wells Score with D-dimer <1000 ng/mL is effective at ruling out PE without imaging

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+====Wells Criteria====
 {| class="wikitable"
 |-
-! Pre-test Probability !! Total Points
+! Clinical Features !! Points
 |-
-| Low || < 2.0
+| Symptoms of [[DVT]] (leg swelling and pain with palpation) || 3.0
 |-
-| Moderate || 2.0-6.0
+| [[PE]] as likely as or more likely than an alternative diagnosis || 3.0
 |-
-| High || > 6.0
+| HR >100 bpm || 1.5
 |-
+| Immobilization for >3 consecutive days or surgery in the previous 4 weeks || 1.5
+|-
+| Previous [[DVT]] or PE || 1.5
+|-
+| Hemoptysis || 1.0
+|-
+| Malignancy (receiving treatment, treatment stopped within 6 mon, palliative care) || 1.0
 |}
+=====Two Tier Wells Score=====
+*Score 0-4 = PE Unlikely (12.1% incidence of PE)
+**Check [[D-dimer]]
+***If D-dimer positive then obtain CTPA or V/Q scan
+***If D-dimer negative, no further workup needed (0.5% incidence of PE at 3 month follow up)
+*Score >4 = PE Likely (37.1% incidence of PE)
+**Obtain CT Pulmonary Angiography or V/Q Scan
+*New evidence suggests lower Wells Score with D-dimer <1000 ng/mL is effective at ruling out PE without imaging