From the Guidelines
The scale for assessing Deep Vein Thrombosis (DVT) risk is the Wells score.
Key Components of the Wells Score
- The Wells score incorporates signs, symptoms, and risk factors for VTE to categorize patients into groups according to their probability of DVT 1.
- The score stratifies patients as having a low, moderate, or high probability of DVT, with a prevalence of DVT of 5.0%, 17%, and 53%, respectively 1.
- A modification of the Wells score stratifies patients as being likely or unlikely to have DVT, with a prevalence of DVT of 28% and 6%, respectively 1.
Limitations of the Wells Score
- The Wells score has limitations, including interobserver reliability and performance in primary care settings 1.
- The score should be used in combination with other diagnostic tools, such as D-dimer testing and compression ultrasound (CUS), to confirm or refute the diagnosis of DVT 1.
Clinical Application
- The Wells score is a useful tool for assessing DVT risk, but it should be used in conjunction with clinical judgment and other diagnostic tests to ensure accurate diagnosis and treatment 1.
From the Research
Scales for Assessing Deep Vein Thrombosis (DVT) Risk
- The Wells scale is a clinically validated scoring system used to assess the probability of DVT in patients, as demonstrated in a study published in the Thrombosis journal 2.
- The Autar DVT risk assessment scale is another tool used to separate risk into no risk, low, moderate, and high risk categories, founded on Virchow's triad in the genesis of DVT 3.
- A comparison of the Autar scale and Wells criteria in DVT risk assessment by nurses in patients with lower extremity trauma found a significant and direct statistical relationship between the results of risk assessment of these two tools 4.
- The Wells criteria have been shown to be a reliable clinical tool to assess the risk of DVT in trauma patients, with a linear correlation between Wells score and DVT 5.
- The Autar DVT scale has been tested on trauma wards and has produced promising results as a predictive index, with a threshold score of 16 achieving 100% sensitivity and 81% specificity 6.
Key Findings
- The Wells scale has been demonstrated to have a high degree of accuracy in assessing DVT risk in primary care settings 2.
- The Autar DVT risk assessment scale has been shown to have higher sensitivity than the Wells criteria in predicting DVT in patients with lower extremity trauma 4.
- The Wells criteria have been found to be a valid pretest tool for risk stratification in post-trauma patients, with a Wells score of <1 able to reliably rule out the possibility of DVT 5.
- The Autar DVT scale has been recommended for use in diverse clinical specialties, with nurses encouraged to evaluate the best cut-off score to achieve maximum predictive accuracy 3.