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Emergency & Critical Care

Wells Criteria for DVT

Pre-test clinical probability scoring for deep vein thrombosis

Wells DVT Score

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Active cancer (treatment ongoing, or within 6 months, or palliative)+1 Paralysis, paresis, or recent plaster immobilisation of lower extremity+1 Recently bedridden >3 days OR major surgery within past 12 weeks requiring general/regional anaesthesia+1 Localised tenderness along distribution of deep venous system+1 Entire leg swollen+1 Calf swelling >3 cm compared to asymptomatic side (measured 10 cm below tibial tuberosity)+1 Pitting oedema confined to symptomatic leg+1 Collateral (non-varicose) superficial veins+1 Alternative diagnosis at least as likely as DVT (e.g. Baker's cyst, cellulitis, muscle tear)−2

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Wells DVT Score

DVT Probability:

Recommended Workup:

Wells DVT Risk Stratification

Score	Probability	DVT Prevalence	Recommended Action
≤0	Low	~3%	D-dimer; if negative, DVT excluded. If positive → compression US.
1–2	Moderate	~17%	Compression US; if negative + low suspicion → D-dimer
≥3	High	~75%	Compression US; if negative → venography or repeat US in 1 week

Score = sum of positive criteria + (−2 if alternative diagnosis equally likely)
Range: typically −2 to +8

Clinical Note: The Wells DVT criteria were validated in outpatient populations with suspected DVT. In high-probability patients, proceed to imaging regardless of D-dimer. Anticoagulation may be started empirically in high-probability patients while awaiting imaging confirmation.

For clinical decision support only. Not a substitute for professional medical judgment.

Wells Criteria for DVT

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Wells Criteria for DVT

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