Revised Geneva Score Calculator

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The Revised Geneva Score Calculator is a clinical tool used to assess the probability of pulmonary embolism (PE) in patients presenting with symptoms such as shortness of breath, chest pain, or unexplained tachycardia. Pulmonary embolism is a potentially life-threatening condition caused by a blood clot that blocks an artery in the lungs. The Revised Geneva Score helps healthcare providers estimate the likelihood of PE based on clinical factors, guiding decisions about further diagnostic testing, such as D-dimer testing, CT pulmonary angiography, or other imaging studies.

The Revised Geneva Score is based on a set of clinical criteria that are assigned specific point values, which together reflect the probability of PE:

  • Age 65 years or older: 1 point
  • Previous DVT or PE: 3 points
  • Surgery or fracture within the last month: 2 points
  • Active cancer: 2 points
  • Unilateral lower limb pain: 3 points
  • Hemoptysis (coughing up blood): 2 points
  • Heart rate 75-94 beats per minute: 3 points
  • Heart rate 95 beats per minute or more: 5 points
  • Pain on deep palpation of lower limb and unilateral edema: 4 points

The total score is calculated by summing the points assigned to each criterion present in the patient. The overall score is then used to categorize the patient’s risk into one of three groups:

  • Low Probability (0-3 points): Low likelihood of PE; further testing may include a D-dimer test, and if negative, PE can often be ruled out.
  • Intermediate Probability (4-10 points): Moderate likelihood of PE; further evaluation with imaging, such as CT pulmonary angiography, is usually recommended.
  • High Probability (11 points or more): High likelihood of PE; immediate diagnostic imaging and treatment should be considered.

To use the Revised Geneva Score Calculator, the healthcare provider evaluates the patient based on the listed criteria and assigns points for each applicable factor. The points are then summed to generate the total score, which helps determine the clinical probability of PE.

Interpreting the Revised Geneva Score aids in making informed decisions about the next steps in patient care. For low-risk patients, a negative D-dimer test can often rule out PE, avoiding unnecessary imaging and reducing patient exposure to radiation and contrast agents. For patients at intermediate or high risk, more definitive testing is needed to confirm or exclude PE, ensuring timely diagnosis and treatment to prevent complications such as right heart failure or death.

The Revised Geneva Score is valued for its simplicity, ease of use, and reliance solely on clinical variables without requiring laboratory tests, making it particularly useful in settings where immediate access to comprehensive diagnostics may be limited. It provides a standardized approach to assessing PE risk, facilitating rapid triage and appropriate management of patients presenting with symptoms suggestive of PE.

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