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Pulmonary Embolism Pretest Probability

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Pulmonary Embolism Pretest Probability, Wells Clinical Prediction Rule for PE

  • See Also
  1. Pulmonary Embolism
  2. Pulmonary Embolism Diagnosis
  3. Pulmonary Embolism Low Probability Evaluation
  4. Pulmonary Embolism Moderate Probability Evaluation
  5. Pulmonary Embolism High Probability Evaluation
  6. PERC Rule
  7. Revised Geneva Score
  • Criteria
  1. PE more likely than alternatives: 3.0 points
  2. Deep Vein Thrombosis (DVT) suspected: 3.0 points
  3. Tachycardia (pulse >100 beats per minute): 1.5 points
  4. Surgery or immobilization in last 4 weeks: 1.5 points
  5. Prior DVT or Pulmonary Embolism: 1.5 points
  6. Hemoptysis: 1.0 points
  7. Active malignancy: 1.0 points
  • Interpretation
  1. Score 0-2 points: Low PE Probability (3.6% risk)
    1. Positive Likelihood Ratio: 0.1
    2. Negative Likelihood Ratio: 7.6
  2. Score 3-6 points: Moderate PE Probability (20.5% risk)
    1. Positive Likelihood Ratio: 1.3
    2. Negative Likelihood Ratio: 0.7
  3. Score >6 points: High PE Probability (66.7% risk)
    1. Positive Likelihood Ratio: 6.8
    2. Negative Likelihood Ratio: 1.8
  • Interpretation
  • Simplified
  1. Score 4 or less: Unlikely
  2. Score >4: Likely
  3. D-Dimer negative with "unlikely" score safely excludes Pulmonary Embolism
  • References
  1. Tamariz (2004) Am J Med 117(9): 676-84 [PubMed]
  2. Wells (2000) Thromb Haemost 83:416-20 [PubMed]
  3. Wells (2001) Ann Intern Med 135(2): 98-107 [PubMed]