Wells criteria for deep venous thrombosis

Wells criteria for deep venous thrombosis is a risk stratification score and clinical decision rule to estimate the pretest probability for acute deep venous thrombosis (DVT). It is intended to be combined with noninvasive diagnostic tests (e.g. ultrasound or D-dimer) for suspected cases.

  • active cancer (treatment ongoing or within previous 6 months or palliative)
  • paralysis, paresis, or recent immobilization of the lower extremities
  • recently bedridden >3 days and/or major surgery within 4 weeks
  • localised tenderness along the distribution of the deep venous system
  • thigh and calf swollen
  • calf swelling 3 cm >asymptomatic side (measured 10 cm below the tibial tuberosity)
  • strong family history of DVT
  • history of recent trauma (>60 days) to the symptomatic leg
  • pitting oedema; symptomatic leg only
  • dilated superficial veins (non-varicose) in symptomatic leg only
  • hospitalisation with previous 6 months
  • erythema

High risk

  • ≥3 major points and no alternative diagnosis
  • ≥2 major points and ≥2 minor points and no alternative diagnosis

Low risk

  • 1 major point and ≥2 minor points and has an alternative diagnosis
  • 1 major point and ≥1 minor point and no alternative diagnosis
  • 0 major point and ≥3 minor points and has an alternative diagnosis
  • 0 major point and ≥2 minor point and no alternative diagnosis

Moderate risk

  • All other combinations
  • there is controversy as to whether the score is effective for inpatients 2
  • in patients with a history of cancer, the combination of the Wells score and D-dimer may not be appropriate for evaluation 3
  • pretest clinical probability with the Wells score may have a low diagnostic accuracy for isolated distal DVT 4
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Article information

rID: 54751
System: Vascular
Synonyms or Alternate Spellings:

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