Geneva Score (Revised) for Pulmonary Embolism
The rGeneva can risk-stratify patients into low, intermediate or high risk based on history and physical exam alone. Many use it as an alternative to the Wells’ PE criteria to determine those patients that are low enough risk to rule out pulmonary embolism with a d-dimer serum test and avoid the use of CT angiography and ultrasound.
The Revised Geneva Score (rGeneva) risk-stratifies patients for pulmonary embolism (PE).
- The original Geneva score was criticised for inclusion of both a Chest X-ray and arterial blood gas to be applied; the rGeneva does not include these.
- rGeneva is not meant to diagnose but to guide workup and testing by predicting pre-test probability of PE
- The rGeneva score does not require imaging or serum studies for risk stratification
- The rGeneva score does not require clinical gestalt (present in Wells’ PE criteria and often subjective) for risk stratification.
- Physicians continue to have a low threshold for the workup of pulmonary embolism.
- The rGeneva score aids in the reduction of unnecessary imaging studies by identifying low risk patients who can be ruled out for PE with a d-dimer serum test.
- One study suggested a clinical decision rule + d-dimer protocol could reduce imaging by 30%.