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Revised Geneva score: how the points are calculated

The revised Geneva score adds points for eight items in a person suspected of having a pulmonary embolism: age over 65 (1), a previous DVT or PE (3), surgery or a lower-limb fracture within 1 month (2), active cancer (2), pain in one leg (3), coughing up blood (2), heart rate (3 for 75 to 94, or 5 for 95 or more), and pain on deep-vein palpation together with swelling of one leg (4). The total runs from 0 to 22.

Not a medical device. Not a diagnosis or dosing recommendation.

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What is the revised Geneva score?

The revised Geneva score was published by Le Gal, Righini, Roy and colleagues in the Annals of Internal Medicine in 2006. The paper's title places it in the emergency department. It's sometimes called the Le Gal revised Geneva score. Magent's calculator is the original revised score. It isn't the simplified Geneva score and it isn't the Wells score.

This page explains the arithmetic. The band limits appear only in the exact expression the calculator uses, below; this page doesn't give a probability or say what a score means for a particular person.

The revised Geneva formula

revised Geneva = age > 65 (1)
               + previous DVT or PE (3)
               + surgery or lower-limb fracture within 1 month (2)
               + active malignancy (2)
               + unilateral lower-limb pain (3)
               + hemoptysis (2)
               + heart rate 75–94 (3) or ≥ 95 (5)
               + pain on deep-vein palpation and unilateral edema (4)
maximum = 22

Exact expression the calculator uses:

revised Geneva = age>65 (1) + previous_dvt_or_pe (3) + surgery_or_fracture_within_1_month (2) + active_malignancy (2) + unilateral_lower_limb_pain (3) + hemoptysis (2) + heart_rate_75_94 (3) or heart_rate_ge_95 (5) + pain_on_deep_vein_palpation_and_unilateral_edema (4); max 22; bands 0-3, 4-10, 11-22

What each part means

ItemWhat earns pointsPoints
AgeOlder than 651
Previous DVT or PEYes3
Surgery or fractureSurgery under general anesthesia or a lower-limb fracture within 1 month2
Active malignancySolid or blood cancer that is active, or considered cured for less than 1 year2
Unilateral lower-limb painPain in one leg3
HemoptysisCoughing up blood2
Heart rate75 to 94 beats per minute3
95 or more5
Pain on deep-vein palpation and unilateral edemaBoth present4

How the score works

  1. Age. Older than 65 adds 1. Age 65 adds nothing.
  2. History. A previous DVT or PE adds 3. Surgery or a lower-limb fracture within 1 month adds 2. Active malignancy adds 2.
  3. Symptoms. Pain in one leg adds 3. Hemoptysis adds 2.
  4. Heart rate. 75 to 94 adds 3. 95 or more adds 5. The two never both count; 74 or less adds nothing.
  5. Leg examination. Pain on deep-vein palpation and swelling of one leg together add 4. This is one item, not two.
  6. Add them up. The total is 0 to 22.

Inputs come from the user

The record says the person using the calculator assigns each finding as true or false. Magent's calculator doesn't examine anyone. It takes age from 18 to 120 and heart rate from 30 to 220, and returns the total, the maximum of 22, the age and heart rate it used, and a line for each item.

Worked examples

These are the worked examples in Magent's record for the calculator.

Example 1: nothing scores

  1. Age 50 isn't over 65 → 0.
  2. Every finding is false → 0.
  3. Heart rate 70 is 74 or less → 0.
  4. Score = 0 out of 22.

Example 2: heart rate 95

  1. Heart rate 95 → 5.
  2. Everything else is the same as Example 1 → 0.
  3. Score = 5 out of 22.

Values at the boundaries

Each line changes Example 1. All are Magent's expected values for the calculator.

  • Age 65 → 0; age 66 → 1.
  • Heart rate 74 → 0; 75 → 3; 94 → 3; 95 → 5.
  • Pain on deep-vein palpation with unilateral edema → 4.
  • Age 70, a previous DVT or PE, heart rate 95, and pain on deep-vein palpation with unilateral edema → 13.

History of the revised Geneva score

The score comes from Le Gal G, Righini M, Roy PM and colleagues, Prediction of pulmonary embolism in the emergency department: the revised Geneva score, Annals of Internal Medicine, 2006 (volume 144, issue 3, pages 165–171).

When it's used

Magent's record describes the calculator as for suspected pulmonary embolism in the emergency department, the setting named in the 2006 paper's title.

Where it's used

The paper's title names the emergency department. The inputs are age, heart rate, history and findings at the bedside; none is an imaging or lab result.

Who uses it

The person using the calculator assigns every finding. The calculator does the adding.

Limits of the calculation

  • It adds up points. It doesn't confirm or rule out a pulmonary embolism.
  • It's the original revised Geneva score from 2006, not the simplified Geneva score and not Wells.
  • Age 65 doesn't score; the point starts above 65.
  • Pain on deep-vein palpation and unilateral edema is one combined item worth 4.
  • This page doesn't say what a score or band means or what to do with it.

Clinical decisions belong to a qualified clinician who knows the patient.

  • Wells score for PE is a separate point score for suspected pulmonary embolism with its own items and weights.
  • PERC is a separate rule made of yes/no findings rather than weighted points.

Glossary

  • Pulmonary embolism (PE): a blood clot that blocks an artery in the lungs.
  • Deep vein thrombosis (DVT): a blood clot in a deep vein, usually in the leg.
  • Hemoptysis: coughing up blood.
  • Unilateral edema: swelling of one leg.
  • Malignancy: cancer.

Common mistakes

  • Giving age 65 a point. The age point is for older than 65.
  • Adding 3 and 5 for a fast heart rate. It's 3 for 75 to 94 or 5 for 95 or more, never both.
  • Scoring palpation pain and edema separately. They're one item worth 4, and both have to be present.
  • Mixing up the revised and simplified scores. The simplified Geneva score is a separate score.

Source

Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144(3):165-171. DOI: 10.7326/0003-4819-144-3-200602070-00004

Frequently asked questions

How do you calculate the revised Geneva score?

Add 1 for age over 65, 3 for a previous DVT or PE, 2 for surgery or a lower-limb fracture within 1 month, 2 for active malignancy, 3 for pain in one leg, 2 for hemoptysis, 3 or 5 for heart rate, and 4 for pain on deep-vein palpation with swelling of one leg.

What does a revised Geneva score of 4 mean?

This page doesn't give a probability by score or band. It adds up the points; what a score means depends on the person and the clinical context.

What is the highest revised Geneva score?

22.

Is the revised Geneva score the same as the simplified Geneva score?

No. This calculator is the original revised score from 2006. The simplified version is a separate score.

Who developed the revised Geneva score?

Le Gal and colleagues, in a 2006 paper in the Annals of Internal Medicine.