Question

Patient with a history of carcinoma bladder presenting with dyspnoea with clinical signs of DVT and tachycardia. The risk for the patient to develop Pulmonary embolism according to WELL's score

• A. High
• B. Medium
• C. Low
• D. Cannot comment without d-dimer values

Answer 1

The Correct Option is B

The Wells Score is a clinical prediction rule used to estimate the probability of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Different clinical factors contribute to different scores, which can then be used to stratify patients into low, moderate, or high probability categories for PE. 

For this patient, several Wells Score criteria are relevant:

• Cancer (treated within the last 6 months or palliative): +1 point
• Clinical signs and symptoms of DVT (minimum of leg swelling and pain with palpation of deep veins): +3 points
• Heart rate over 100 beats per minute: +1.5 points

Summing these factors gives a total Wells Score of 5.5 points.

Wells Score	Interpretation
0-1	Low probability
2-6	Moderate probability
>6	High probability

The total score of 5.5 places the patient in the 'Moderate Probability' category according to the Wells Score interpretation chart. Therefore, the risk for this patient to develop a Pulmonary Embolism is categorized as "Medium".