Revised Geneva Score

Select each criterion present and enter the patient's heart rate to determine the pretest probability of pulmonary embolism.

Age ≥65 years (1 point)

Previous DVT or PE (3 points)

Surgery or lower limb fracture within 1 month (2 points)

Active malignancy (2 points)

Unilateral lower limb pain (3 points)

Hemoptysis (2 points)

Heart rate (beats/min)

Add 3 points for HR 75–94 bpm, 5 points for ≥95 bpm.

Pain on lower limb deep palpation and unilateral edema (4 points)

Total score

Probability category

Low probability

Low probability of pulmonary embolism. Consider alternative diagnoses or D-dimer testing if suspicion persists.

How to Use This Calculator

Collect objective clinical data

Document age, heart rate, recent surgery, cancer status, and PE/DVT history before applying the score.

Assess symptoms and limb findings

Evaluate for unilateral leg pain, edema, and localized tenderness to gauge thrombotic likelihood.

Determine diagnostic pathway

Use the probability category to decide on D-dimer testing versus immediate imaging, aligned with institutional protocols.

Formula

Revised Geneva Score = 1 (age ≥65) + 3 (previous DVT/PE) + 2 (surgery or fracture within 1 month) + 2 (active malignancy) + 3 (unilateral leg pain) + 2 (hemoptysis) + heart rate points (3 if 75–94 bpm, 5 if ≥95 bpm) + 4 (pain on deep vein palpation and unilateral edema).

Full Description

The Revised Geneva Score is an entirely objective clinical prediction rule for pulmonary embolism. It categorizes patients into low (0–3), intermediate (4–10), or high (≥11) pretest probability, guiding the use of D-dimer testing and imaging. Because it excludes subjective components, it is especially useful when clinician gestalt varies or when standardizing care pathways for suspected PE.

Frequently Asked Questions

How does Geneva differ from Wells?

Geneva uses only objective criteria, whereas Wells includes subjective assessment of alternative diagnoses.

Can I use Geneva in pregnancy?

Pregnancy was not included in derivation studies; apply with caution and consider pregnancy-specific algorithms.

What if heart rate varies?

Use the highest heart rate recorded at presentation. Persistent tachycardia suggests higher probability.

Does anticoagulation status affect scoring?

No. The score reflects current presentation factors, but ongoing anticoagulation may influence diagnostic choices.