Pulmonary Embolism Geneva Score Calculator




Score :

Probabilité :

What Is the Geneva Score?

The Geneva Score is a widely used clinical prediction tool designed to assess the likelihood that a patient is experiencing a pulmonary embolism (PE), which is a potentially life-threatening condition caused by a blood clot blocking one or more arteries in the lungs. Pulmonary embolism can develop suddenly and requires prompt medical attention, but its symptoms can often mimic other health issues, making early diagnosis challenging. That’s where the Geneva Score becomes a helpful resource.

The score relies solely on objective clinical factors that can be easily identified through patient history and a basic physical examination. These factors include the patient’s age, previous history of venous thromboembolism, recent surgery or immobilization, active cancer, symptoms like leg pain or swelling, hemoptysis (coughing up blood), and elevated heart rate. Each of these factors is assigned a specific number of points based on how strongly they are associated with PE.

Once all applicable factors are checked, the total score is calculated. The final result classifies the patient into one of three categories: low, moderate, or high probability of pulmonary embolism. This classification helps healthcare providers decide on the next steps, such as whether additional testing like a D-dimer test or a CT pulmonary angiogram is needed.

Because it avoids the need for lab work or imaging at the initial stage, the Geneva Score is especially useful in emergency departments, outpatient settings, and areas where quick, efficient assessment is critical. However, it’s important to remember that the Geneva Score is only a screening tool and should not replace clinical judgment or more definitive diagnostic methods.

When Should You Use This Calculator?

You should use the Pulmonary Embolism Geneva Score Calculator when there is a clinical suspicion of pulmonary embolism (PE), especially in situations where quick assessment is needed to determine the likelihood of PE before ordering more advanced tests. This tool is most helpful for healthcare professionals in emergency rooms, clinics, or outpatient settings where patients present with symptoms such as:

  • Sudden shortness of breath
  • Chest pain that worsens with deep breathing or coughing
  • Rapid or irregular heartbeat
  • Unexplained coughing, sometimes with blood (hemoptysis)
  • Swelling or pain in one leg, particularly in the calf

The calculator is designed to support—but not replace—clinical judgment. It provides a quick way to estimate the probability of PE based on key clinical factors. It can be especially useful:

  • Before ordering diagnostic tests such as D-dimer or CT angiography
  • In primary care or urgent care settings where immediate imaging is not available
  • To stratify risk and guide decisions on patient management or referral

How the Geneva Score Works

The Geneva Score works by assigning a specific number of points to various clinical risk factors that are known to be associated with pulmonary embolism (PE). These factors are based on a patient’s medical history, symptoms, and simple physical findings. Each factor reflects the statistical likelihood of PE being present, and the total score helps categorize the patient’s overall risk.

The original and revised Geneva Scores use objective data only—meaning no subjective clinical judgment is required—which makes the scoring system more consistent and reliable. Here’s how it works:

  1. Each relevant risk factor is checked if it applies to the patient.
  2. Each selected item adds a certain number of points to the total score.
  3. The total score is then calculated automatically by the tool.
  4. Based on the total points, the patient is classified into a low, moderate, or high probability category for pulmonary embolism.

This classification helps guide further diagnostic steps. For example:

  • Low probability: PE is less likely, and additional testing may not be needed if other signs are also reassuring.
  • Moderate probability: Further testing like a D-dimer blood test may be appropriate to rule out PE.
  • High probability: Immediate imaging (such as a CT pulmonary angiogram) and treatment may be considered without delay.

Scoring Criteria Explained

The Geneva Score is based on a set of objective clinical criteria. Each item contributes a specific number of points to the overall score, which helps determine the probability that a patient has a pulmonary embolism (PE). Below is a detailed explanation of each criterion used in the calculator:

1. Age over 65

Patients aged over 65 years are at increased risk for PE. This criterion adds 1 point to the total score.

2. Previous History of Thrombosis or Pulmonary Embolism

A personal history of deep vein thrombosis (DVT) or pulmonary embolism significantly increases the risk of recurrence. This adds 3 points to the score.

3. Recent Surgery or Immobility (within the past month)

Surgical procedures or being immobilized (such as bed rest or a cast) reduce blood flow, increasing clot risk. This adds 2 points.

4. Active Cancer or Cancer in Remission for Less Than a Year

Cancer, especially when active or recently treated, raises the risk of blood clots. This contributes 2 points to the score.

5. Leg Pain or Tenderness (especially in the calf)

Spontaneous pain in one leg, especially the calf, can be a sign of deep vein thrombosis, a major cause of PE. This symptom adds 3 points.

6. Calf Swelling or Pain on Palpation

Swelling or tenderness when pressing on the calf muscles may indicate DVT. This adds 4 points to the score.

7. Coughing Up Blood (Hemoptysis)

Hemoptysis can be a sign of lung tissue damage caused by a blood clot. This symptom adds 2 points.

8. Heart Rate Between 75–94 bpm

A slightly elevated heart rate may suggest the body is compensating for reduced oxygen from a potential PE. This adds 3 points.

9. Heart Rate Over 94 bpm

A significantly high heart rate is a more serious warning sign. This adds 5 points and automatically overrides the previous heart rate category.

Once all relevant factors are selected, the calculator adds the points together to estimate the overall probability of PE and guide further steps.

How to Use the Calculator

The Pulmonary Embolism Geneva Score Calculator is designed to be quick and easy to use, especially in clinical or urgent care settings. It helps estimate the likelihood that a patient is experiencing a pulmonary embolism (PE) based on specific medical criteria. Follow the steps below to use the calculator effectively:

  1. Review the list of risk factors: You’ll see a list of checkboxes next to various clinical indicators such as age, medical history, symptoms, and vital signs.
  2. Select all factors that apply: For each item that is true for the patient, check the corresponding box. The calculator automatically assigns a point value to each selected item.
  3. Choose only one heart rate category: If the patient’s heart rate is between 75–94 bpm, select that box. If it is over 94 bpm, select the other one. The calculator will prevent both from being selected at once to avoid double-counting.
  4. Click the "Calculate" button: After selecting all relevant checkboxes, press the "Calculate" button located below the checklist. The calculator will instantly compute the total score.
  5. View the results:
    • Score: This is the total number of points based on the selected criteria.
    • Probability: This indicates the estimated likelihood of PE:
      • 0–3 points: Low probability
      • 4–10 points: Moderate probability
      • 11 or more points: High probability
  6. Take appropriate action: Use the result to guide your next steps, such as ordering further diagnostic tests, referring the patient, or ruling out PE if the score is very low and no other signs are concerning.

Understanding Your Result

After using the Geneva Score Calculator, you'll receive two outputs: a numerical score and a probability level indicating the risk of pulmonary embolism (PE). This result helps determine the next steps in diagnosis or management. Here’s what each category means:

What a Low Probability Score Means (0–3 points)

A low probability score suggests that the likelihood of a pulmonary embolism is minimal. In many cases, if the patient has no other concerning symptoms or risk factors, further testing such as a D-dimer blood test may not be necessary. However, if clinical suspicion remains high, doctors may still recommend additional evaluation. Always consider the full clinical picture.

What a Moderate Probability Score Means (4–10 points)

A moderate probability score indicates that there is a significant chance the patient may have a PE. This typically requires further diagnostic testing, such as a D-dimer test or imaging (e.g., CT pulmonary angiogram), to confirm or rule out the diagnosis. Prompt evaluation is important to prevent complications if a PE is present.

What a High Probability Score Means (11 or more points)

A high probability score suggests a strong likelihood of pulmonary embolism. In this case, immediate diagnostic imaging and possibly urgent treatment may be necessary, even before test results are available. Early detection and intervention can be lifesaving, so this score level should always be taken seriously.

What to Do Next Based on Your Score

Once you receive your Geneva Score and its corresponding probability level, it’s important to take the right steps based on the result. The score provides an estimate—not a diagnosis—and should be followed by appropriate clinical decisions or testing. Here’s a general guide to what you should do next based on your score:

Low Probability (0–3 points)

  • In many cases, no immediate imaging is needed if no other strong signs of PE are present.
  • A D-dimer blood test may be used to further rule out PE.
  • If the D-dimer test is negative, PE can usually be excluded safely without further testing.
  • Monitor symptoms and reassess if they worsen or persist.

Moderate Probability (4–10 points)

  • Further diagnostic testing is usually recommended.
  • A D-dimer test may still be appropriate; if it’s positive, imaging such as a CT pulmonary angiogram may be ordered.
  • Timely follow-up is important to confirm or rule out PE and prevent complications.

High Probability (11 or more points)

  • Urgent imaging, such as a CT pulmonary angiogram or ventilation-perfusion (V/Q) scan, is typically recommended.
  • In some cases, treatment (such as anticoagulation) may begin even before imaging results are available, depending on clinical urgency.
  • Immediate medical evaluation is essential—this is considered a potential emergency.

Frequently Asked Questions (FAQ)

1. Who should use the Geneva Score Calculator?

The calculator is designed for use by healthcare professionals such as doctors, nurses, and medical staff to help assess the probability of pulmonary embolism (PE) based on clinical signs and history. It is not intended for self-diagnosis or use by the general public.

2. Can this calculator confirm if I have a pulmonary embolism?

No, the Geneva Score does not confirm the presence of PE. It is a clinical prediction tool that helps estimate the likelihood of PE and guides decisions about further testing. A confirmed diagnosis requires imaging and/or blood tests.

3. What should I do if my score shows a high probability?

If your score indicates a high probability of PE, seek immediate medical attention. A high score suggests a strong chance of pulmonary embolism, and prompt diagnostic imaging and treatment may be necessary.

4. What’s the difference between the Geneva Score and the Wells Score?

Both are clinical tools used to assess PE risk. The Geneva Score uses only objective criteria, such as age, heart rate, and medical history. The Wells Score includes some subjective judgment by the clinician, such as the likelihood of PE being the most probable diagnosis.

5. Can I use this calculator more than once?

Yes, the calculator can be used as often as needed. It's helpful in various clinical situations, especially when new symptoms arise or if the patient's condition changes.

6. Is the Geneva Score accurate?

The Geneva Score has been validated in clinical studies and is considered reliable for estimating PE probability. However, it should always be used alongside clinical judgment and not as the sole basis for decision-making.

7. What if two heart rate options apply to my patient?

The calculator is designed to accept only one heart rate category. If the heart rate is over 94 bpm, you should select that option, which overrides the lower category. Do not select both.

8. What happens if I don’t meet any of the criteria?

If none of the criteria apply, your score will be 0, indicating a very low probability of PE. Even so, always consider the full clinical picture and consult with a healthcare provider if symptoms persist or worsen.

Disclaimer

The Pulmonary Embolism Geneva Score Calculator is provided for educational and informational purposes only. It is intended to assist healthcare professionals in estimating the probability of pulmonary embolism (PE) based on established clinical criteria. This tool is not a substitute for professional medical advice, diagnosis, or treatment.

While the calculator uses evidence-based guidelines, it should not be relied upon as the sole basis for clinical decision-making. Always consider the complete clinical context, additional tests, and individual patient factors before making any diagnosis or treatment plan.

If you are a patient or a member of the general public, do not use this calculator to self-diagnose or make healthcare decisions. If you are experiencing symptoms such as chest pain, shortness of breath, or coughing up blood, seek immediate medical attention from a qualified healthcare provider.

The developers of this tool and the website hosting it are not responsible for any medical outcomes resulting from the use or misuse of the calculator. Use of this tool constitutes acceptance of these terms.

References

  • Rosen's Emergency Medicine: Concepts and Clinical Practice – Kline, J.A. & Ma, O.J. – 2023 – Elsevier
  • Deep Vein Thrombosis and Pulmonary Embolism – Goldhaber, S.Z. – 2016 – Wiley-Blackwell
  • Tintinalli’s Emergency Medicine: A Comprehensive Study Guide – Tintinalli, J.E. – 2019 – McGraw-Hill Education
  • Hematology: Basic Principles and Practice – McLintock, C., Brighton, T., & Chunilal, S. – 2018 – Elsevier
  • Users' Guides to the Medical Literature – Guyatt, G. & Rennie, D. – 2015 – McGraw-Hill