Wells score of Pulmonary Embolism

[Al-Husein]

The Wells score of Pulmonary Embolism:
* Clinically suspected DVT - 3.0 points
* PE Is #1 Diagnosis, or Equally Likely - 3.0 points
* Tachycardia - 1.5 points
* Immobilisation or surgery in the previous four weeks - 1.5 points
* History of DVT or PE - 1.5 points
* Haemotypsis - 1.0 points
* Malignancy (treatment for within six months, palliative) - 1.0 points.

Traditional interpretation:
* Score >6.0 - High score
* 2.0 to 6.0 - Moderate score
* <2.0 - Low.

Alternate interpretation score:
* > 4 - PE likely. Consider diagnostic imaging
* Score 4 or less - PE unlikely. Consider D dimer to rule out PE.

[heyam]

thank you ...i found it easy and not complicated

[heyam]

but iwant to add aquestion what is D -diamer? it realy confusing me
thanks again

[Al-Husein]

What is D dimer? how can it help me?

[Al-Husein]

D-Dimer now is a primary screening investigation in suspected cases of pulmonary embolism, it is fast, cheap (comparing to radiological alternatives) mmm but it has a problem that it can be false -ve in pregnancy, otherwise, a normal D-Dimer virtually excludes pulmonary embolism (of thrombotic origin)

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D-dimer is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two crosslinked D fragments of the fibrinogen protein.

D-dimer concentration may be determined by a blood test to help diagnose thrombosis. Since its introduction in the 1990s, it has become an important test performed in patients suspected of thrombotic disorders. While a negative result practically rules out thrombosis, a positive result can indicate thrombosis but does not rule out other potential causes. Its main use, therefore, is to exclude thromboembolic disease where the probability is low. In addition, it is used in the diagnosis of the blood disorder disseminated intravascular coagulation.