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 1, and revised and simplified in 2006 2. 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 3,4.
Original Geneva score
It ranges from 0 to 16 points and results in 3 clinical probability categories: low, intermediate, and high risk 1.
- 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 2. A "simplified" revised Geneva score has also been used in which each of the below criteria are assigned 1 point if positive 4.
- 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