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DVT Probability: Wells Score System

Select Criteria:

Clinical Findings

Paralysis, paresis or recent orthopedic casting of lower extremity (1 point)

Recently bedridden (more than 3 days) or major surgery within past 4 weeks (1 point)

Localized tenderness in deep vein system (1 point)

Swelling of entire leg (1 point)

Calf swelling 3 cm greater than other leg (measured 10 cm below the tibial tuberosity) (1
point)

Pitting edema greater in the symptomatic leg (1 point)

Collateral non varicose superficial veins (1 point)

Active cancer or cancer treated within 6 months (1 point)

Alternative diagnosis more likely than DVT (Baker's cyst, cellulitis, muscle damage,
superficial venous thrombosis, post phlebitic syndrome, inguinal lymphadenopathy, external venous
compression) (-2 points)

Results:

Total Criteria Point Count:

DVT Risk Score Interpretation

3-8 Points: High probability of DVT

1-2 Points: Moderate probability

-2-0 Points: Low Probability

References
Wells’ Criteria for DVT

Calculates Wells' Score for risk of DVT.

Active cancerYESNO+1

Bedridden recently >3 days or major surgery within four weeksYESNO+1

Calf swelling >3 cm compared to the other legYESNO+1

Collateral (nonvaricose) superficial veins presentYESNO+1

Entire leg swollenYESNO+1

Localized tenderness along the deep venous systemYESNO+1

Pitting edema, greater in the symptomatic legYESNO+1

Paralysis, paresis, or recent plaster immobilization of the lower extremityYESNO+1

Previously documented DVTYESNO+1

Alternative diagnosis to DVT as likely or more likely

Wells prediction score for deep vein thrombosis (DVT)

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The clinical diagnosis of DVT is generally thought to be unreliable. However, Wells et al. suggest a
well-validated clinical prediction rule which could be used to estimate the pretest probability. This
suggests whether a patient is at low, moderate or high risk of having suffered a DVT which may
guide subsequent investigation and management (1).

The revised Wells score or criteria for assessment of suspected DVT is mentioned below (with a
possible score of -2 to 9):

Factor Points

active cancer (treatment within last six months or palliative) 1

calf swelling ≥3 cm compared to asymptomatic calf (measured 10 cm below tibial tuberosity) 1

collateral superficial veins (non-varicose) 1

pitting oedema (confined to symptomatic leg) 1

swelling of entire leg 1

localised tenderness along distribution of deep venous system 1

paralysis, paresis, or recent cast immobilisation of lower extremities 1

recently bedridden ≥3 days, or major surgery requiring regional or general anesthetic in the previous
12 weeks 1

previously documented deep-vein thrombosis 1

alternative diagnosis at least as likely as DVT -2