About

The Revised Geneva Score is a validated clinical prediction rule used to determine the pre-test probability of Pulmonary Embolism (PE). Unlike the original score, the Revised version relies entirely on objective variables, eliminating the need for arterial blood gas analysis or subjective clinician judgment regarding "likelihood". This standardization makes it highly suitable for rapid assessment in emergency departments.

This tool allows for risk stratification using both the traditional Three-level schema (Low, Intermediate, High) and the simplified Two-level schema (PE Unlikely, PE Likely). Accurate stratification helps minimize unnecessary CT pulmonary angiography (CTPA) scans by identifying patients who can be safely managed with D-dimer testing alone.

Formulas

The total score G is the summation of weighted objective criteria. The interpretation depends on the chosen clinical schema:

Three-Level Interpretation:

{

High (≥60%) if G ≥ 11Intermediate (≈28%) if 4 ≤ G ≤ 10Low (<10%) if G ≤ 3

Note: Heart rate points are mutually exclusive (select the highest applicable bracket).

Reference Data

Variable	Points
Age > 65 years	+1
Previous DVT or PE	+3
Surgery (general anesthesia) or Fracture (lower limb) within 1 month	+2
Active Malignancy (solid or hematologic)	+2
Unilateral lower limb pain	+3
Hemoptysis	+2
Heart Rate 75 - 94 bpm	+3
Heart Rate ≥ 95 bpm	+5
Pain on lower limb deep venous palpation and unilateral edema	+4

Frequently Asked Questions

The Original Geneva Score included arterial blood gas (PaO2, PaCO2) and a chest X-ray interpretation, which made it cumbersome. The Revised score uses only history and physical examination findings, making it faster and purely objective.

The score assigns different weights to heart rate tiers. A rate of 75-94 bpm gets 3 points. A rate of 95 bpm or higher gets 5 points. These are not cumulative; you assign points for the specific range the patient falls into.

The Two-level (or dichotomous) interpretation simplifies the result into "PE Unlikely" (Score 0-5) and "PE Likely" (Score > 5). This is often used in conjunction with high-sensitivity D-dimer testing to rule out PE efficiently.