DVT Scores

## DVT & PE Prediction Rules

#### Constans Score - Upper Extremity DVT Prediction Rule

+1 Venous Material (indwelling catheter)

+1 Localized Pain

+1 Unilateral Pitting Edema

-1 Other diagnosis more plausible

Probability of Upper Extremity DVT

-1 or 0: low (9-13%)

1: intermediate

2 or 3: high (64-70%)

#### Well's Score for DVT - DVT Prediction Rule

+1 Active cancer (treatment within last 6 months or palliative)

+1 Calf swelling ≥ 3cm compared to asymptomatic calf (measured 10cm below tibial tuberosity)

+1 Swollen unilateral superficial veins (non-varicose, in symptomatic leg)

+1 Unilateral pitting edema (in symptomatic leg)

+1 Previous documented DVT

+1 Swelling of entire leg

+1 Localized tenderness along the deep venous system

+1 Paralysis, paresis, or recent cast immobilization of lower extremities

+1 Recently bedridden ≥ 3 days, or major surgery requiring regional or general anesthetic in the past 12 weeks

-2 Alternative diagnosis at least as likely

Probability of DVT:

-2 to 0: low (5%)

1-2: moderate (17%)

3+: high (53%)

#### Geneva Score (Revised) - Pulmonary Embolism Prediction Rule

+1 Age 65 years or over

+3 Previous DVT or PE

+2 Surgery or fracture within 1 month

+2 Active malignant condition

+3 Unilateral lower limb pain

+2 Hemoptysis

+3 Heart rate 75 to 94 beats per minute

+5 Heart rate 95 or more beats per minute

+4 Pain on deep palpation of lower limb and unilateral edema

Probability of PE:

0 - 3: low (8%)

4 - 10: intermediate (29%)

11+: high (74%)

#### Well's Score for PE

+3 Clinically suspect DVT

+3 Alternative diagnosis is less likely than PE

+1.5 HR > 100

+1.5 Immobilization (≥ 3d)/surgery in previous four weeks

+1.5 History of DVT or PE

+1 Hemoptysis

+1 malignancy (with treatment within six months) or palliative

Probability of PE:

>6.0+: high (59%)

2.0 to 6.0: moderate (29%)

<2.0: low (15%)

Alternate Interpretation:

> 4: likely. Consider V/Q or CT-PE

4 or less: unlikely. Consider d-dimer