What is the revised Geneva clinical scoring system for pulmonary embolism?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Answer

Another validated clinical prediction rule for use in the diagnosis of pulmonary embolism is the revised Geneva score (see Table 2, below). [10] The performance of this scoring system appears equivalent to that of the Wells score [9] ; however, it should be mentioned that emerging evidence suggests the Wells score to be more accurate. [11, 12]

The Geneva criteria, which depend only on objective measures, lead to a stratification with a pulmonary embolism prevalence of 8% in the lowest-risk group (Geneva score of 0)—a prevalence too high to be neglected. Table 2. Revised Geneva Score*

Table 2. (Open Table in a new window)

Risk Factors

Points

Age older than 65 y

1

Previous DVT or pulmonary embolism

3

Surgery (under general anesthesia) or fracture (of the lower limbs) within 1 mo

2

Active malignant condition (solid or hematologic, currently active or considered cured < 1 y)

2

Symptoms

 

Unilateral lower limb pain

3

Hemoptysis

2

Clinical Signs

 

Heart rate 75-94 beats/min

3

Heart rate ≥95 beats/min

5

Pain on lower limb deep venous palpation and unilateral edema

4

Clinical Probability

Score

Low

0-3 total

Intermediate

4-10 total

High

≥11 total

*Adapted from Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, Perrier A. Ann Intern Med. 2006 Feb 7;144(3):165-71.

To see complete information on pulmonary embolism, please see the Medscape Drugs & Diseases article Pulmonary Embolism.


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