Calculate the Revised Geneva Score for pulmonary embolism probability. Objective, standardized PE risk assessment using 8 clinical criteria without subjective judgment.
The Revised Geneva Score is a validated clinical prediction rule for estimating the pre-test probability of pulmonary embolism (PE). Unlike the Wells score, which includes the subjective criterion "PE is the most likely diagnosis," the Revised Geneva Score uses exclusively objective criteria, making it fully standardized and reproducible across different clinicians.
Developed by Le Gal et al. in 2006, the score uses 8 clinical variables: age, prior VTE, recent surgery or fracture, active malignancy, unilateral leg pain, hemoptysis, heart rate, and leg edema with deep vein tenderness. The total score stratifies patients into low (0-3), intermediate (4-10), and high (≥11) probability categories.
The Revised Geneva Score has been validated in multiple large multicenter studies and is endorsed alongside the Wells score for PE probability assessment. Its objective nature makes it particularly valuable for research, quality metrics, and settings where standardization is prioritized.
The key advantage of the Revised Geneva Score over the Wells score is its complete objectivity. No criterion requires the clinician to decide whether PE feels like the leading diagnosis, so inter-observer variability is lower.
This page is most useful as a risk-framing worksheet. It turns the standard 8 variables into one reproducible pretest-probability band without pretending the score alone decides D-dimer use, imaging, or treatment.
Revised Geneva Score: Age 65-75: +1 | Age >75: +2 Previous DVT/PE: +3 Surgery or fracture (≤1 month): +2 Active malignancy: +2 Unilateral lower limb pain: +3 Hemoptysis: +2 HR 75-94: +3 | HR ≥95: +5 Pain on DVP palpation + unilateral edema: +4 Range: 0-22 0-3: Low (8%) | 4-10: Intermediate (29%) | ≥11: High (74%)
Result: Revised Geneva Score 10 — Intermediate Probability
Age >75 (2 pts) + prior DVT/PE (3 pts) + HR ≥95 (5 pts) = 10 points. That lands in the intermediate-probability band with approximately 29% PE prevalence in validation cohorts. The score is best used to frame the rest of the PE workup, not to replace it.
The Revised Geneva Score is best used as an objective pretest-probability layer. It helps structure the early PE discussion before D-dimer, imaging, and the wider differential are fully integrated.
Lower and intermediate score bands are often reviewed with D-dimer-first pathways, while higher score bands more often push the conversation toward imaging-first review. The exact sequence still depends on the local protocol, pregnancy status, hemodynamic stability, and the rest of the case.
Because every variable is objective, the score is easier to standardize across clinicians and systems than gestalt-heavy tools. That makes it useful for pathways and documentation, but it still should not be mistaken for a complete PE management algorithm.
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This calculator applies the Revised Geneva Score using the published objective criteria and point weights, then groups the result into the usual low-, intermediate-, and high-probability categories for pulmonary embolism. Because the score is entirely objective, the page keeps the criteria visible and emphasizes how the result fits into the broader PE workup rather than treating it as a final diagnosis.
The output is intended to structure pre-test probability before D-dimer or imaging. It does not replace clinical judgment in pregnancy, atypical populations, or hemodynamically unstable presentations, and it should be used alongside the diagnostic pathway that matches the patient's setting and local guideline standard.
Both scores have similar diagnostic accuracy for PE. The Wells score is more widely used in North America, while the Revised Geneva Score is favored in Europe. Choose the Geneva score when objectivity is important (protocols, EMR decision support) and the Wells score when clinical gestalt adds value. Either is acceptable per ESC and ACEP guidelines.
A simplified Revised Geneva Score assigns 1 point to each criterion (instead of variable weights). The simplified version is easier to calculate and has comparable accuracy: low (0-1), intermediate (2-4), high (≥5). It is commonly used in clinical practice and is validated in many studies.
Age is a continuous risk factor for PE. The Geneva score uses cutoffs: ages 65-75 add 1 point, >75 adds 2 points. This reflects the exponential increase in PE incidence with age (from <1 per 1000 at age 30 to >5 per 1000 at age 80). Age-adjusted D-dimer thresholds (age × 10 μg/L) further improve the algorithm in elderly patients.
The Revised Geneva Score has not been specifically validated in pregnancy. Pregnant patients have altered physiology (higher heart rate, changed hemostasis) and different PE risk profiles. Specific pregnancy PE algorithms using V/Q scan and compression ultrasonography are recommended.
Active malignancy means cancer diagnosed within the past 6-12 months, active treatment (chemotherapy, radiation), or metastatic/advanced disease. Cancer in remission for several years and adequately treated non-melanoma skin cancer generally do not count. Cancer-associated VTE has unique pathophysiology and treatment considerations.
The score counts heart rate regardless of etiology. A patient tachycardic from fever, pain, or anxiety will score higher even if the tachycardia is not from PE. This is a limitation — but tachycardia from any cause in a patient where PE is considered warrants investigation, as PE often coexists with other conditions.