Revised Geneva Score: Difference between revisions
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== Objective == | == Objective == | ||
The Revised Geneva Score is a [[Clinical Prediction Rules| | The Revised Geneva Score is a [[Clinical Prediction Rules|clinical prediction rule]] for [[Pulmonary Embolism|pulmonary embolism]] (PE) developed by Le Gal et al in 2006. Based on patient history and physical exam, it aims to risk-stratify patients into low, intermediate, and high-risk categories. | ||
PE is ruled out in low-risk patients through a d-dimer serum test while high-risk patients are to undergo additional imaging studies such as CT angiography and ultrasound. | |||
== Intended Population == | == Intended Population == | ||
The Revised Geneva Score and [[Deep Vein Thrombosis#Clinical Prediction Rule .28CPR.29: Well.27s Criteria|Well's Criteria]] are the most widely used scores to assess individuals for PE. | |||
== Method of Use == | == Method of Use == | ||
'''Revised Geneva | '''Revised Geneva Score''' <ref>Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, Perrier A. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Annals of internal medicine. 2006 Feb 7;144(3):165-71.</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
|+ | |+ | ||
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!'''Points''' | !'''Points''' | ||
|- | |- | ||
|'''Risk factors''' | |||
| | |||
|- | |- | ||
|Age >65 y | |Age >65 y | ||
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|2 | |2 | ||
|- | |- | ||
|Active malignant condition (solid or hematologic malignant condition, currently active or | |Active malignant condition (solid or hematologic malignant condition, currently active or considered cured <1 y) | ||
considered cured <1 y) | |||
|2 | |2 | ||
|- | |- | ||
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|2 | |2 | ||
|- | |- | ||
| colspan="2" |'''Clinical | | colspan="2" |'''Clinical Signs''' | ||
|- | |- | ||
|75–94 beats/min | |75–94 beats/min | ||
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|<u>></u>11 total | |<u>></u>11 total | ||
|} | |} | ||
== Evidence == | == Evidence == | ||
=== Reliability === | === Reliability === | ||
* In a prospective study spanning over 8 months, results show that the Revised Geneva score can be used in emergency department patients with high reliability.<ref>Calisir C, Yavas US, Ozkan IR, Alatas F, Cevik A, Ergun N, Sahin F. Performance of the Wells and Revised Geneva scores for predicting pulmonary embolism. European journal of emergency medicine. 2009 Feb 1;16(1):49-52.</ref> | |||
* A retrospective study by Girardi et al (2020) showed that the Revised Geneva Score and Well's Criteria are not reliable predictors of PE in critically ill patients.<ref>Girardi AM, Bettiol RS, Garcia TS, Ribeiro GL, Rodrigues ÉM, Gazzana MB, Rech TH. Wells and Geneva scores are not reliable predictors of pulmonary embolism in critically ill patients: a retrospective study. Journal of intensive care medicine. 2020 Oct;35(10):1112-7.</ref> | |||
=== Validity === | === Validity === | ||
* The Revised Geneva Score is classified as Level 1 in terms of validation which means it has a high level of validation according to methodological standards developed for clinical prediction rules. <ref>Ceriani E, Combescure C, Le Gal G, Nendaz M, Perneger T, Bounameaux H, Perrier A, Righini M. [https://www.jthjournal.org/article/S1538-7836(22)12404-9/fulltext Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis]. Journal of thrombosis and haemostasis. 2010 May 1;8(5):957-70.</ref> | |||
* It is important to note that the Revised Geneva Score is currently used for emergency departments and has not yet been validated in inpatients with suspected PE. <br> | |||
== References == | == References == | ||
<references /> | <references /> | ||
[[Category:Clinical Prediction Rules]] | |||
[[Category:Primary Contact]] | |||
[[Category:Cardiopulmonary]] | |||
[[Category:Cardiopulmonary - Guidelines]] | |||
Latest revision as of 03:55, 3 May 2024
Original Editor - Carina Therese Magtibay
Top Contributors - Carina Therese Magtibay
Objective[edit | edit source]
The Revised Geneva Score is a clinical prediction rule for pulmonary embolism (PE) developed by Le Gal et al in 2006. Based on patient history and physical exam, it aims to risk-stratify patients into low, intermediate, and high-risk categories.
PE is ruled out in low-risk patients through a d-dimer serum test while high-risk patients are to undergo additional imaging studies such as CT angiography and ultrasound.
Intended Population[edit | edit source]
The Revised Geneva Score and Well's Criteria are the most widely used scores to assess individuals for PE.
Method of Use[edit | edit source]
Revised Geneva Score [1]
| Variables | Points |
|---|---|
| Risk factors | |
| Age >65 y | 1 |
| Previous DVT or PE | 3 |
| Surgery (under general anesthesia) or fracture (of the lower limbs) within 1 month | 2 |
| Active malignant condition (solid or hematologic malignant condition, currently active or considered cured <1 y) | 2 |
| Symptoms | |
| Unilateral lower-limb pain | 3 |
| Hemoptysis | 2 |
| Clinical Signs | |
| 75–94 beats/min | 3 |
| >95 beats/min | 5 |
| Pain on lower-limb deep venous palpation and unilateral edema | 4 |
| Clinical Probability | |
| Low | 0-3 total |
| Intermediate | 4–10 total |
| High | >11 total |
Evidence[edit | edit source]
Reliability[edit | edit source]
- In a prospective study spanning over 8 months, results show that the Revised Geneva score can be used in emergency department patients with high reliability.[2]
- A retrospective study by Girardi et al (2020) showed that the Revised Geneva Score and Well's Criteria are not reliable predictors of PE in critically ill patients.[3]
Validity[edit | edit source]
- The Revised Geneva Score is classified as Level 1 in terms of validation which means it has a high level of validation according to methodological standards developed for clinical prediction rules. [4]
- It is important to note that the Revised Geneva Score is currently used for emergency departments and has not yet been validated in inpatients with suspected PE.
References[edit | edit source]
- ↑ Le Gal G, Righini M, Roy PM, Sanchez O, Aujesky D, Bounameaux H, Perrier A. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Annals of internal medicine. 2006 Feb 7;144(3):165-71.
- ↑ Calisir C, Yavas US, Ozkan IR, Alatas F, Cevik A, Ergun N, Sahin F. Performance of the Wells and Revised Geneva scores for predicting pulmonary embolism. European journal of emergency medicine. 2009 Feb 1;16(1):49-52.
- ↑ Girardi AM, Bettiol RS, Garcia TS, Ribeiro GL, Rodrigues ÉM, Gazzana MB, Rech TH. Wells and Geneva scores are not reliable predictors of pulmonary embolism in critically ill patients: a retrospective study. Journal of intensive care medicine. 2020 Oct;35(10):1112-7.
- ↑ Ceriani E, Combescure C, Le Gal G, Nendaz M, Perneger T, Bounameaux H, Perrier A, Righini M. Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis. Journal of thrombosis and haemostasis. 2010 May 1;8(5):957-70.
