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