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🌱 來自: pulmonary embolism

Modified Wells Pretest Probability Scoring for PE

compare: clinical prediction rules for the diagnosis of pulmonary embolism

• Wells
  • Patient characteristic: Clinically suspected DVT
  • Unilateral leg swelling
  • Heart rate >100/min
  • Immobilization or surgery within the previous 4 wk
  • Previous DVT or PE
  • Hemoptysis
  • Cancer within 6 mo
  • Alternative diagnosis is less likely than pulmonary embolism

Low or moderate clinical probability of PE

• Clinical gestalt probability of PE is low (<15%) and ≥1 items of the PERC score are positive;
• Or clinical gestalt probability of PE is moderate (15%-40%) and D-dimer testing is recommended
• Wells score ≤4 or YEARS criteria not present:
  • Use D-dimer threshold of 1000 ng/mL
• Wells score > 4 or YEARS criteria present:
  • Use age-adjusted D-dimer threshold

High clinical probability of PE

• Clinical gestalt probability of PE is high (>40%)
  • Or Wells score > 6 or Geneva score > 10