🫁 Wells Score for Pulmonary Embolism
UseGuide D-dimer vs CT pulmonary angiography in suspected PE.
StrataThree-level: >6 high, 2–6 intermediate, <2 low. Two-level: >4 PE likely / ≤4 PE unlikely — unlikely + negativ…
LimitsUnlikely + negative D-dimer can exclude; likely or positive D-dimer →… · Combine with PERC and age-adjusted D-dimer when eligible. · Subjective “PE most likely” item drives inter-rater variability.
SourceEuropean layer: 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism de…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with suspected acute PE when deciding whether to test further, and risk stratification after confirmation.
- Who it is not for
- PERC must not rule out PE when clinical probability is not already low. Confirmed PE does not return to PERC. PERC is not an atrial-fibrillation tool and not a treatment page.
- Formula and variables
- Wells PE and revised Geneva estimate clinical probability; the version stays as on this page. PERC is used only when probability is already low, to see whether testing can stop. BOVA is only for normal blood pressure. Hestia only answers outpatient eligibility. No new score.
- Result → next step
- If probability is low and every PERC item is negative, stop further PE testing; otherwise test. The treatment column stays empty before confirmation. After confirmation, duration opens the anticoagulation-duration page. That link is not hung on PERC. Numeric dose waits for age, weight, renal function, and pregnancy.No numeric dose until age, weight, renal function, and pregnancy are all known. Pregnancy is contraindication or caution only.Duration after confirmation →
- Guideline
- 2019 ESC PE
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Methodology · worked example, guidelines & full notes
Unlikely + negative high-sensitivity D-dimer excludes PE (consider PERC).
When to use
Guide D-dimer vs CT pulmonary angiography in suspected PE.
How it works
Weighted items (DVT signs 3, PE most likely 3, HR > 100 1.5, immobilisation/surgery 1.5, prior VTE 1.5, haemoptysis 1, malignancy 1). Two-level: > 4 likely, ≤ 4 unlikely.
Key points
- Unlikely + negative high-sensitivity D-dimer excludes PE (consider PERC).
- Likely → CT pulmonary angiography.
- Three-level bands: < 2 low, 2–6 moderate, > 6 high.
References
- [Guideline / primary source]European layer: 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) (Konstantinides SV, et al. Eur Heart J 2020;41(4):543-603. doi:10.1093/eurheartj/ehz405)
- [Guideline / primary source]US layer: 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults (Creager MA, et al. Circulation 2026;153(12):e977-e1051. doi:10.1161/CIR.0000000000001415). It lists the Wells score alongside the revised Geneva score and PERC as pretest-probability tools: with low or intermediate clinical probability, PE can be excluded with an age-adjusted D-dimer or the YEARS strategy; high probability or a raised D-dimer leads to CTPA. Wells categories and thresholds on this page are unchanged; the European layer remains ESC 2019.
- [Guideline / primary source]Same guideline, simultaneous JACC publication: J Am Coll Cardiol 2026;87(13):1626-1710. doi:10.1016/j.jacc.2025.11.005
- Wells PS, et al. Ann Intern Med 2001; Thromb Haemost 2000
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Clinical signs of DVT | No |
|---|---|
| PE is the most likely diagnosis | No |
| Heart rate > 100/min | No |
| Immobilisation/surgery within 4 weeks | No |
| Previous DVT/PE | No |
| Haemoptysis | No |
| Malignancy (treated within 6 months) | No |
→Wells (PE)0.0
- Two-level：PE unlikely → D-dimer (consider PERC); if negative, PE excluded.
- Three-level：Low
| Clinical signs of DVT | Yes (+3) |
|---|---|
| PE is the most likely diagnosis | Yes (+3) |
| Heart rate > 100/min | Yes (+1.5) |
| Immobilisation/surgery within 4 weeks | Yes (+1.5) |
| Previous DVT/PE | Yes (+1.5) |
| Haemoptysis | Yes (+1) |
| Malignancy (treated within 6 months) | Yes (+1) |
→Wells (PE)12.5
- Two-level：PE likely → CT pulmonary angiography.
- Three-level：High
Verification & sources · governance
FAQ
Frequently asked questions
- Does Wells Score for Pulmonary Embolism upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Wells Score for Pulmonary Embolism calculated in practice? Can you show a worked example?
- Inputs: Clinical signs of DVT No, PE is the most likely diagnosis No, Heart rate > 100/min No, Immobilisation/surgery within 4 weeks No, Previous DVT/PE No, Haemoptysis No, Malignancy (treated within 6 months) No → Result: Wells (PE) 0.0（Two-level: PE unlikely → D-dimer (consider PERC); if negative, PE excluded., Three-level: Low） Inputs: Clinical signs of DVT Yes (+3), PE is the most likely diagnosis Yes (+3), Heart rate > 100/min Yes (+1.5), Immobilisation/surgery within 4 weeks Yes (+1.5), Previous DVT/PE Yes (+1.5), Haemoptysis Yes (+1), Malignancy (treated within 6 months) Yes (+1) → Result: Wells (PE) 12.5（Two-level: PE likely → CT pulmonary angiography., Three-level: High）