Clinical prediction rules for pulmonary embolism
Wells score [23] | Revised Geneva score [24] | ||||
Variable | Points | Variable | Points | ||
Active cancer | +1 | Age >65 yrs | +1 | ||
Haemoptysis | +1 | Active cancer | +2 | ||
Previous DVT or PE | +1.5 | Haemoptysis | +2 | ||
Heart rate >100 beats·min−1 | +1.5 | Previous DVT or PE | +3 | ||
Surgery or bed rest ≥3 days within 1 month | +1.5 | Surgery or lower limb fracture within 1 month | +2 | ||
Clinical signs of DVT | +3 | Unilateral oedema and pain at palpation | +4 | ||
No alternative diagnosis as more likely than PE | +3 | Spontaneously reported calf pain | +3 | ||
Heart rate 75–94 beats·min−1 | +3 | ||||
Heart rate ≥95 beats·min−1 | +5 | ||||
Clinical probability | Points | PE % | Clinical probability | Points | PE % |
Low | <2 | 2–6 | Low | ≤3 | 7–12 |
Intermediate | 2–6 | 17–24 | Intermediate | 4–10 | 22–31 |
High | ≥7 | 54–78 | High | ≥11 | 58–82 |
Clinical probability (dichotomised) | |||||
PE unlikely | ≤4 | 8–13 | |||
PE likely | >4 | 37–56 |
DVT: deep venous thrombosis; PE: pulmonary embolism.