Diagnostic Accuracy of Well's Score in Clinically Suspected Deep Venous Thrombosis

Abstract

The Wells scoring system for risk assessment of developing
Deep Venous Thrombosis (DVT) is primarily designed to be used
in the outpatient settings. We aimed to determine the validity,
discrimination ability, and clinical utility of Wells scoring system
in risk stratification of patients suspected of DVT in an inpatient
setting in Saudi Arabia as compared to another outpatient
population. All Patients who underwent lower limb Doppler
ultrasound at King Abdulaziz University Hospital between
January 2016 and July 2017 and were suspected to have DVT
are included. A total of 1934 clinically-suspected DVT patients
are analyzed (34.6% males and 65.4% females). 53.62% were
outpatients and 31.8% were inpatients. Doppler ultrasound
confirmed DVT in 304 patients. Incidence of DVT in outpatients
was 5.9% for low probability; 8% for moderate probability; 18.5%
for high probability, whereas the inpatients had an incidence of
4.1% for low probability; 8.4% for moderate probability; 15.7%
for high probability. The negative predictive value of Wells score
in outpatients is 94.1% and 95.9% for inpatients. Results of Well’s
score demonstrate an excellent discrimination ability in ruling
out DVT in both the outpatient and inpatient settings.