Wells Score for PE

Wells Score for Pulmonary Embolism

Select all criteria present:

Clinical signs of DVT

Lower limb edema and/or pain on palpation of the deep veins

+3 points

PE is the most likely diagnosis

Clinical judgment that PE is the most probable diagnosis or at least as likely as any alternative

+3 points

Heart rate > 100 bpm

Tachycardia

+1.5 points

Immobilization or surgery in the past 4 weeks

Immobilization ≥ 3 days or any surgery in the past 4 weeks

+1.5 points

Prior PE or DVT

Previously documented history of venous thromboembolism

+1.5 points

Hemoptysis

Coughing up blood from the respiratory tract

+1 point

Active malignancy

On treatment, treated within the last 6 months, or receiving palliative care

+1 point

Wells Score Interpretation

Three-level version — Wells et al., Thromb Haemost 2000

Score	Probability	PE prevalence
< 2	Low	~3.6%
2 to 6	Moderate	~20.5%
> 6	High	~66.7%

Dichotomized version — van Belle et al. (Christopher Study), JAMA 2006

Score	Classification	Management
≤ 4	PE unlikely	D-dimer; if negative, PE excluded
> 4	PE likely	CT pulmonary angiography (CTPA) directly

Note: The Wells Score is a risk stratification tool that must be used alongside clinical judgment. It does not replace individualized medical assessment. In high-probability patients, empirical anticoagulation may be considered while awaiting imaging if the bleeding risk is acceptable. The American College of Emergency Physicians (ACEP) and the American Heart Association (AHA) endorse clinical decision rules including the Wells Score as part of structured PE evaluation pathways in the emergency setting.

References

1. Wells PS, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000;83(3):416–20. PubMed ↗
2. van Belle A, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-Dimer testing, and computed tomography. JAMA. 2006;295(2):172–9. PubMed ↗

Calculamedica

Wells Score for PE

Result

Wells Score Interpretation