Revised Geneva clinical prediction rule for pulmonary embolism
Determine pre-test probability for pulmonary embolism
The revised Geneva score is a decision tool that helps determine probability of pulmonary embolism. It can be used as an alternative to the Wells’ pulmonary embolism criteria. The revised Geneva score does not require the use of clinical gestalt, which is a distinguishing feature of this clinical decision rule.
For those patients identified as low risk (score 0-3), there is a <10% incidence of PE.
For those patients identified as intermediate risk (score 4-10), there is a 20-30% incidence of PE. A negative d-dimer test could prompt discontinuation of further workup.
For those patients identified as high risk (score 11 or higher), there is a >:60% incidence of PE. In these patients, consider CT and/or US. If imaging is negative, consider angiography
High clinical suspicion for pulmonary embolism warrant imaging regardless of Geneva score.
Gregory Le Gal, Marc Righini , Pierre-Marie Roy , Olivier Sanchez , Drahomir Aujesky , Henri Bounameaux , Arnaud Perrier