Purpose: Well’s Criteria was developed in order to predict the likelihood of the presence of a deep vein thrombosis (DVT) prior to radiological intervention.
Rule:
Clinical Characteristic | Score |
Active cancer (patient receiving treatment for cancer within the previous 6 mo or currently receiving palliative treatment) | +1 |
Paralysis, paresis, or recent plaster immobilization of the lower extremities | +1 |
Recently bedridden for 3 days or more, or major surgery within the previous 12 wk requiring general or regional anesthesia | +1 |
Localized tenderness along the distribution of the deep venous system | +1 |
Entire leg swollen | +1 |
Calf swelling at least 3 cm larger than that on the asymptomatic side (measured 10 cm below tibial tuberosity) | +1 |
Pitting edema confined to the symptomatic leg | +1 |
Collateral superficial veins (nonvaricose) | +1 |
Previously documented deep-vein thrombosis | +1 |
Alternative diagnosis at least as likely as deep-vein thrombosis | -2 |
> 3: High Probability
1-2: Moderate Probability
0: Low Probability
Research:
1. Hargett CW, et al. Clinical probability and D-dimer testing: How should we use them in clinical practice? Semin Respir Crit Care Med. 2008; 29(1): 15–24.
2. Wells PS, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. The New England Journal of Medicine. 2003; 349(13): 1227-1235. doi:10.1056/NEJMoa023153.
3. Wells PS, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997; 350: 1795-1798.
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