Pulmonary embolism probability scoring

From WikiProjectMed
Jump to navigation Jump to search

The Wells score is used to determine the probability of a pulmonary embolism based on a person's history and examination. There is additionally a Wells score for deep vein thrombosis.

Use

Wells score[1]
Criteria Points Points
(simplified)
Present
Symptoms or signs of deep vein thrombosis 3 1 <html><input class="wells-item" type="checkbox" value="30" onclick="window.wellsScore(this);" /></html>
Autres diagnostics moins probables 3 1 <html><input class="wells-item" type="checkbox" value="30" onclick="window.wellsScore(this);" /></html>
FC > 100/min 1.5 1 <html><input class="wells-item" type="checkbox" value="15" onclick="window.wellsScore(this);" /></html>
Immobilisation (≥ 3 jours) ou chirurgie récente (< 4 semaines) 1.5 1 <html><input class="wells-item" type="checkbox" value="15" onclick="window.wellsScore(this);" /></html>
Antécédents de thrombose veineuse profonde ou d'embolie pulmonaire 1.5 1 <html><input class="wells-item" type="checkbox" value="15" onclick="window.wellsScore(this);" /></html>
Hémoptysies 1 1 <html><input class="wells-item" type="checkbox" value="10" onclick="window.wellsScore(this);" /></html>
Cancer 1 1 <html><input class="wells-item" type="checkbox" value="10" onclick="window.wellsScore(this);" /></html>
Probability Faible
Probability (simplified) Peu probable

  • Original version: low (0-1), intermediate (2-6), high (>6)[note 1]
  • Simplified: low probability (0-1), higher probability (>1)[note 2]

<html><script type="text/javascript">

if(typeof window.wellsScore === 'undefined') {

window.wellsScore = function(element)
{
 var score = 0;
 $(element).closest("table").find("input[type=checkbox]").filter(":checked").each(function(){
  score += parseInt($(this).attr("value").replace(",", "."));
 });
 
 score /= 10; // parseFloat is not defined in chrome !!!!!????
 // Original version
 var element = $(element).closest("table").find(".wells-score-result");
 if(score < 2){ $(element).css("color", "green").html("Faible"); }
 else if(score < 7){ $(element).css("color", "orange").html("Intermédiaire"); }
 else if(score > 6){ $(element).css("color", "red").html("Élevé"); }
 else { $(element).css("color", "red").html("Erreur"); }
 // Simplified version
 element = $(element).closest("table").find(".simplified-wells-score-result");
 if(score < 2){ $(element).css("color", "green").html("Peu probable"); }
 else { $(element).css("color", "red").html("Plus probable"); }
}

}

</script></html>

Voir aussi

Notes

  1. Pour le risque faible, on estime la probabilité à moins de 19%, pour le risque intermédiaire, il est entre 10% et 79% et pour le risque élevé, il est supérieur à 80%.
  2. 12% des cas d'EP seront décrits comme peu probables.

References

  1. Wells, PS; Anderson, DR; Rodger, M; Stiell, I; Dreyer, JF; Barnes, D; Forgie, M; Kovacs, G; Ward, J; Kovacs, MJ (17 July 2001). "Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer". Annals of internal medicine. 135 (2): 98–107. doi:10.7326/0003-4819-135-2-200107170-00010. PMID 11453709.