Geneva Score

Geneva Scoring for Pulmonary Embolism Simplified Further

A further simplification of the Geneva score to evaluate the likelihood of pulmonary embolism retains the diagnostic accuracy of the original, reports Archives of Internal Medicine.

Researchers evaluated the simplified approach retrospectively in some 1050 patients with suspected pulmonary embolism. Instead of receiving symptom-weighted scores, the patients received 1 point for each the following factors:

• age over 65
• history of deep venous thrombosis or pulmonary embolism
• surgery under general anesthesia or lower-limb fracture within 1 month
• active malignancy
• unilateral lower-limb pain
• hemoptysis
• heart rate between 75 and 94, or 95 and above
• pain on lower-limb palpation and unilateral edema

Patients with scores of 2 or less were considered unlikely to have pulmonary embolism under the revised scoring. Although no patients in the "unlikely" group with normal D-dimer levels developed pulmonary embolism during 3 months' follow-up, the authors estimate that in clinical practice, the probability of pulmonary embolism would be up to 3% in this patient population.

Archives of Internal Medicine article