:

Practical-Haemostasis.com



A Practical Guide to Haemostasis


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.

Click HERE to Reset



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
Hear 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