A COMPARISON BETWEEN WELLS’ SCORE AND MODIFIED DOPPLER ULTRASOUND IN THE DIAGNOSIS OF DEEP VENOUS THROMBOSIS OF THE LOWER LIMB

The assessment of the probability of occurrence of deep vein thrombosis played a very important part in making a correct diagnosis and modified Wells’ score is a widely used prediction rule for pre-test probability assessment. We aimed to evaluate the diagnostic accuracy of the modified Wells’ score in the diagnosis of lower extremity deep vein thrombosis compared to Doppler ultrasound study. This is a cross-sectional study conducted in Baghdad Teaching Hospital from Jan 2017 till Dec 2017. Adults inpatients suspected of having lower-extremity deep vein thrombosis were included after taking verbal consents. Patients on antithrombotic treatment and those suspected to have pulmonary embolism were excluded. According to Wells’ score; patients were divided into likely and unlikely groups. Lower extremity venous duplex ultrasound study was established. Correlation of Wells’ score with DVT and its efficacy was analyzed using receiver operating characteristic curve. A total number of 113 patients were included; with a mean age of 40.6 ±, 12.7 years and males were 60 (53.1%). Based upon Wells’ score, 45 (39.8%) patients were found to be likely to have DVT. Doppler ultrasound was positive for DVT in 48 (70.6%) patients of those who belong to the likely group with a statistically significant difference. The overall accuracy of Wells’ score was 76.1%, and sensitivity was higher than the specificity. In this study; Wells’ score demonstrated a high degree of accuracy. As an initial diagnostic tool; if we use Wells’ score with a prior assumption; it has benefited as exclusion tool than a confirmatory test.