🫁 Pulmonary Embolism Pathway (Wells-PE + D-dimer)
Work up suspected pulmonary embolism with the two-tier Wells score and an age-adjusted D-dimer, and get the guideline next step. Instant, browser-side.
Clinical takeaway
PE likely (> 4) → CTPA directly; a negative D-dimer does not exclude PE here.
Loading calculator…
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
When to use
Decide whether to exclude PE, order a D-dimer, or proceed to CTPA in a haemodynamically stable patient.
How it works
Wells-PE (DVT signs 3, PE most likely 3, HR > 100 1.5, immobilisation/surgery 1.5, prior VTE 1.5, haemoptysis 1, malignancy 1); > 4 = PE likely. Age-adjusted D-dimer cut-off = age × 10 µg/L FEU for age > 50.
Key points
- PE likely (> 4) → CTPA directly; a negative D-dimer does not exclude PE here.
- PE unlikely (≤ 4) → D-dimer below the (age-adjusted) cut-off excludes PE without imaging.
- The age-adjusted cut-off applies only to patients > 50 with low clinical probability.
- Haemodynamically unstable patients are treated as high-risk PE and do not follow this pathway.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Frequently asked questions
- What is Pulmonary Embolism Pathway (Wells-PE + D-dimer)?
- Work up suspected pulmonary embolism with the two-tier Wells score and an age-adjusted D-dimer, and get the guideline next step. Instant, browser-side.
- How is Pulmonary Embolism Pathway (Wells-PE + D-dimer) calculated? What is the core formula?
- Wells-PE (DVT signs 3, PE most likely 3, HR > 100 1.5, immobilisation/surgery 1.5, prior VTE 1.5, haemoptysis 1, malignancy 1); > 4 = PE likely. Age-adjusted D-dimer cut-off = age × 10 µg/L FEU for age > 50.
- When is Pulmonary Embolism Pathway (Wells-PE + D-dimer) used?
- Decide whether to exclude PE, order a D-dimer, or proceed to CTPA in a haemodynamically stable patient.
- What are the key clinical points for Pulmonary Embolism Pathway (Wells-PE + D-dimer)?
- PE likely (> 4) → CTPA directly; a negative D-dimer does not exclude PE here. PE unlikely (≤ 4) → D-dimer below the (age-adjusted) cut-off excludes PE without imaging. The age-adjusted cut-off applies only to patients > 50 with low clinical probability. Haemodynamically unstable patients are treated as high-risk PE and do not follow this pathway.
- What are the limits and cautions when using Pulmonary Embolism Pathway (Wells-PE + D-dimer)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.