Wells Score Calculator for Pulmonary Embolism (PE)

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Objective leg swelling and pain on palpation along the deep venous system. Worth +3 points.
Clinician judgment: PE is number one on the differential or tied with another diagnosis. Worth +3 points.
Documented tachycardia above 100 beats per minute. Worth +1.5 points.
Bed rest for 3 or more consecutive days, OR any surgical procedure within the past 4 weeks. Worth +1.5 points.
Prior episode of DVT or pulmonary embolism confirmed by objective testing (ultrasound, V/Q scan, CTPA, etc.). Worth +1.5 points.
Patient is coughing up blood or blood-stained sputum. Worth +1 point.
Active cancer receiving treatment, cancer treated within the past 6 months, or cancer in the palliative setting. Worth +1 point.
The 3-level model (Wells 2000) gives Low, Moderate, and High categories. The 2-level model (Wells 2001 simplified) classifies PE as unlikely (0-4) or likely (> 4).
Wells ScoreLow Probability
0

Sum of all selected criteria points (max 12.5)

Risk CategoryLow Probability
Approximate PE Incidence~1-3% confirmed PE
Suggested Next StepD-dimer testing is recommended. Consider applying the PERC rule first in emergency settings: if all 8 PERC criteria are absent, PE can be excluded without D-dimer. A negative D-dimer effectively rules out PE in low-probability patients.
0 pts
Low<2Moderate2-6High6+

Wells Score: 0.0 - Low Probability

  • No criteria are selected. The score of 0 places this patient in the lowest risk group, with PE confirmed in roughly 1-3% of similar presentations.
  • In published validation studies, approximately ~1-3% confirmed PE among patients in the Low Probability group were found to have PE on definitive imaging.
  • The Wells Score guides, but does not replace, clinical judgment. Factors such as oxygen saturation, chest X-ray findings, and ECG changes should be integrated with this score.

Next stepConsider applying the PERC rule. If PERC-negative, no further workup may be needed. Otherwise, order D-dimer.

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