DVT 2-level Well's score

Question 1

What version of the Wells Score does NICE recommend for DVT?

Answer 1

The 2-level DVT Wells Score (DVT likely or unlikely).

Question 2

How many points indicate that DVT is likely according to the Wells Score?

Answer 2

2 points or more.

Question 3

How many points indicate that DVT is unlikely?

Answer 3

1 point or less.

Question 4

What score is assigned for active cancer (treatment ongoing, within 6 months, or palliative) in the Wells Score?

Answer 4

1 point.

Question 5

What score is given for paralysis, paresis, or recent plaster immobilisation of the lower extremities?

Answer 5

1 point.

Question 6

How many points for being recently bedridden for 3 days or more, or major surgery within 12 weeks requiring general or regional anaesthesia?

Answer 6

1 point

Question 7

What score is assigned for localized tenderness along the deep venous system?

Answer 7

1 point.

Question 8

How many points for entire leg swollen?

Answer 8

1 point.

Question 9

What score is given for calf swelling at least 3 cm larger than the asymptomatic side?

Answer 9

1 point.

Question 10

How many points for pitting oedema confined to the symptomatic leg?

Answer 10

1 point.

Question 11

What score is assigned for collateral superficial veins (non-varicose)?

Answer 11

1 point.

Question 12

What is the next step if the Wells Score indicates DVT is likely (≥2 points)?

Answer 12

Offer a proximal leg vein ultrasound scan within 4 hours if possible; if not, perform a D-dimer test and consider interim anticoagulation.

Question 13

What should be done if the ultrasound scan is negative but the D-dimer test is positive?

Answer 13

Repeat ultrasound scan after 6–8 days to exclude false negatives.

Question 14

What is the recommended management if the ultrasound scan is positive for DVT?

Answer 14

Start anticoagulation treatment unless contraindicated; consider mechanical interventions if anticoagulation is contraindicated.