EVALUATING THE EFFICACY OF THE WELLS SCORE FOR DIAGNOSING DEEP VEIN THROMBOSIS IN CHRONIC KIDNEY DISEASE PATIENTS

Abstract

Background: Chronic kidney disease (CKD) patients have an increased risk of deep venous thrombosis (DVT) due to coagulation and vascular dysfunction. While the Wells Scoring System is commonly used to predict DVT risk, its accuracy in CKD patients is not well established. Objective: To evaluate the diagnostic performance of the Wells Scoring System in detecting DVT among CKD patients. Methods: A descriptive cross-sectional study was conducted over six months at Lady Reading Hospital, Peshawar. Eighty-five CKD patients (≥18 years) with clinical signs of DVT were consecutively enrolled. Wells scores were calculated prior to compression duplex ultrasonography, which served as the diagnostic gold standard. Data analysis was performed using SPSS 25.0, with a Wells score threshold of ≥2 for DVT risk. Results: DVT was confirmed in 32 patients (37.6%). For a Wells score ≥2, sensitivity was 90.6%, specificity 60.4%, positive predictive value (PPV) 58.0%, and negative predictive value (NPV) 91.4%. Visual data included patient distribution by Wells risk categories and Wells score correlation with ultrasound findings. Conclusion: The Wells Scoring System shows high sensitivity and NPV in CKD patients, making it useful for ruling out DVT. However, moderate specificity necessitates confirmatory imaging. These findings support integrating the Wells score into DVT diagnostic protocols for CKD patients, with awareness of its limitations.