geneva score

The Geneva score is a clinical decision rule used to estimate the pre-test probability of pulmonary embolism (PE) in patients in which this diagnosis was considered. The criteria were originally published by the clinical team of the Geneva University Hospital in 2001 , and revised and simplified in 2006 . A potential advantage of its utilization in comparison to the Wells criteria is the absence of an enumerated criterion regarding an individual clinician's gestalt, which may allow a greater degree of standardization .

Original Geneva score

It ranges from 0 to 16 points and results in 3 clinical probability categories: low, intermediate, and high risk .

• age
  • 60–79 years = 1
  • 80+ years = 2
• history of previous venous thromboembolism: DVT or PE = 2
• recent surgery within 4 weeks = 3
• heart rate
  • >100 bpm = 1
• PaCO2 (partial pressure of CO2 in arterial blood)
  • <35mmHg = 2
  • 35-39mmHg = 1
• PaO2 (partial pressure of O2 in arterial blood)
  • <49mmHg = 4
  • 49-59mmHg = 3
  • 60-71mmHg = 2
  • 72-82mmHg = 1
• chest radiograph
  • band atelectasis = 1
  • elevation of hemidiaphragm = 1

Probability of pulmonary embolism:

• low probability < 5 points
• intermediate probability 5 - 8 points
• high probability >8 points

Revised Geneva score  

The revised geneva score eliminates the need for information gleaned from a chest radiograph or an arterial blood gas sample, ranging now from 0 to 22 points and results in 3 clinical probability categories: low, intermediate, and high risk . A "simplified" revised Geneva score has also been used in which each of the below criteria are assigned 1 point if positive .

• age 65 years or over = 1
• history of previous venous thromboembolism: DVT or PE = 3
• recent surgery or fracture within 1 month = 2
  • fracture must involve lower limbs
  • surgery must require anesthesia
• active malignant condition = 2
  • includes hematologic or solid malignancies
  • also encompasses malignancies cured within the preceding year
• unilateral lower limb pain = 3
• pain on palpation along the deep veins of the lower limb and unilateral edema = 4
• hemoptysis = 2
• heart rate
  • 75 - 94 bpm = 3
  • 95 bpm or more = 5

Probability of pulmonary embolism:

• low probability 0-3 points
• intermediate probability 4-10 points
• high probability >10 points

See also

• Wells score
• pulmonary embolism rule-out criteria (PERC)

Siehe auch:

• Lungenarterienembolie