The GENEVA Scores

Venous Thromboembolic Disease [VTED:
The Revised GENEVA Prediction Score
The Simplified GENEVA Risk Prediction Score
The Original GENEVA Risk Prediction Score

Introduction

The Revised GENEVA score is a clinical prediction rule used to determine the pre-test probability of Pulmonary Embolism [PE] based on a patient's risk factors and clinical findings.

The Revised GENEVA Score:

Select Criteria:

Age >65 years
	1 Point
Previous DVT and or PE
	3 Points
Surgery [under GA] or Lower Limb fracture in previous 4 weeks
	2 Points
Active Malignancy [solid or haematological - currently active or considered cured within 12 months]
	2 Points
Unilateral lower limb pain
	3 Points
Haemoptysis
	2 Points
Heart Rate
75-94bpm	3 Points
≥95bpm	5 Points
Pain on lower limb deep venous palpation and unilateral oedema
	4 Points

Score

[Max score 22 Points]

Interpretation
0 - 3	Low clinical probability for PE
4 - 10	Intermediate clinical probability for PE D-dimer testing: Negative: Consider stopping further investigation Positive: Imaging indicated
≥ 11	High clinical probability for PE >60% probability of PE. Imaging indicated

The Revised GENEVA score has some limitations - see References for additional information.

The Simplified Geneva Risk Prediction Score

A simplified version of the Geneva Score has been generated and is summarised below:

Variable		Score
Age	>65 yrs	1 Point
Previous VTE event	Yes	1 Point
Previous Surgery or fracture within 4 weeks	Yes	1 Point
Active malignancy	Yes	1 Point
Unilateral lower limb pain	Yes	1 Point
Haemoptysis	Yes	1 Point
Pain on deep palpation of the lower limb and unilateral oedema	Yes	1 Point
Heart Rate 75 -94bpm Heart Rate >94bpm	Yes Yes	1 Points 2 Points
Maximum Score	9 Points
Interpretation	<2 Points - low probability of PE

The Original Geneva Risk Prediction Score

The original Geneva risk prediction score is summarised below:

Variable		Score
Age	60 - 79 yrs 8-+ yrs	1 2
Previous VTE event	Yes No	2 0
Previous Surgery within 4 weeks	Yes No	3 0
Heart rate >100bpm	Yes No	1 0
PaCO₂ [Arterial blood]	<35 mmHg 35 - 39 mmHg	2 1
PaO₂ [Arterial blood]	<49 mmHg 49 - 59 mmHg 60 - 71 mmHg 72 - 82 mmHg	4 3 2 1
CXR	Band atelectasis Elevated hemidiaphragm	1 1
Maximum Score	16
Interpretation	<5 Points - low probability of PE 5 - 8 Points - moderate probability of PE >8 Points - high probability of PE

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