Revised Geneva Score Calculator for Pulmonary Embolism
Stratify pulmonary embolism probability using the validated Revised Geneva Score — a 10-criterion clinical decision rule for PE risk assessment.
Answer each clinical criterion with Yes or No to calculate the Revised Geneva Score and determine the pre-test probability of pulmonary embolism.
Revised Geneva Score Calculator for Pulmonary Embolism
Stratify pulmonary embolism probability using the validated Revised Geneva Score — a 10-criterion clinical decision rule for PE risk assessment.
About the Revised Geneva Score calculator
Pulmonary embolism (PE) is a life-threatening blockage of one or more pulmonary arteries by a blood clot, most commonly originating from deep vein thrombosis (DVT) in the legs. Because PE can present with non-specific symptoms — chest pain, shortness of breath, tachycardia — clinicians rely on validated clinical decision tools to estimate pre-test probability and guide diagnostic workup.
The Revised Geneva Score (RGS) is one of the most widely used and validated scoring systems for PE probability stratification. Originally developed by Le Gal and colleagues in 2006, the score was revised from the original Geneva Score to remove the need for an arterial blood gas measurement, making it fully applicable at the bedside using history and physical examination alone.
The tool evaluates ten clinical variables, each contributing a specific point value. Age greater than 65 years adds 1 point, reflecting that older patients have greater thrombotic risk. A history of previous DVT or PE adds 3 points, as prior thromboembolic events are one of the strongest risk factors for recurrence. Recent surgery requiring general anaesthesia or a bone fracture within the past month adds 2 points due to the hypercoagulable state they induce.
Active malignancy — defined as cancer currently under treatment or diagnosed within the past six months — adds 2 points. Unilateral lower limb pain, often felt in the calf or thigh, adds 3 points as it may represent the source DVT. Haemoptysis (coughing up blood) adds 2 points as a classic symptom of pulmonary infarction.
Elevated heart rate contributes 3 points for rates between 75 and 94 bpm and 5 points for rates of 95 bpm or more, reflecting the physiological compensatory response to reduced cardiac output. These two heart-rate criteria are mutually exclusive — only the applicable range should be selected. Pain on deep palpation of a lower limb vein and unilateral lower limb oedema each add 4 points.
Score interpretation follows a three-tier framework. A total score of 0 to 3 indicates low probability, with PE incidence below 15% in clinical studies. A score of 4 to 10 indicates moderate probability, with PE incidence of 15 to 40%. A score of 11 or more indicates high probability, with PE incidence above 40%.
This tool is intended for use by qualified healthcare professionals as a clinical decision aid. It should be interpreted alongside clinical assessment, imaging, and D-dimer testing in accordance with current diagnostic guidelines. It does not replace clinical judgement.
Revised Geneva Score examples
Three clinical scenarios illustrating different pre-test probability categories.
| Clinical Scenario | Score & Category | Key Contributing Factors |
|---|---|---|
| Young patient, no risk factors, no symptoms beyond mild shortness of breath | Score 0 — Low Probability (<15%) | No positive criteria. PE is unlikely; D-dimer testing and clinical monitoring may suffice without CT pulmonary angiography. |
| Patient >65 with unilateral leg pain and heart rate 80 bpm | Score 7 — Moderate Probability (15–40%) | Age >65 (+1), unilateral leg pain (+3), heart rate 75–94 bpm (+3). Imaging workup is recommended. |
| Patient with previous PE, tachycardia ≥95 bpm, leg palpation pain, leg edema, and haemoptysis | Score 18 — High Probability (>40%) | Previous DVT/PE (+3), haemoptysis (+2), HR ≥95 (+5), leg pain on palpation (+4), leg edema (+4). Emergency CT pulmonary angiography is indicated. |
| Moderate case: Previous PE, active cancer, unilateral leg pain | Score 8 — Moderate Probability (15–40%) | Previous DVT/PE (+3), active malignancy (+2), unilateral leg pain (+3). Combined risk factors warrant prompt imaging. |
How to use the Revised Geneva Score calculator
- For each of the ten criteria, select Yes if the finding is present or No if it is absent.
- Ensure you consider both heart rate fields: select Yes for '75–94 bpm' if the patient's rate falls in that range, or Yes for '≥ 95 bpm' if it is 95 or higher, but not both.
- Click Calculate Revised Geneva Score to see the total score and pre-test probability category.
- Use the score to guide diagnostic decision-making: low probability may support D-dimer testing alone, moderate/high probability typically warrants CT pulmonary angiography.
- Click Reset to clear all answers and start a new assessment for a different patient.
Revised Geneva Score FAQ
What is the Revised Geneva Score used for?
The Revised Geneva Score is a validated clinical decision rule used to estimate the pre-test probability of pulmonary embolism (PE) in adult patients presenting with symptoms such as chest pain, dyspnoea, or unexplained tachycardia. It stratifies patients into low, moderate, or high probability categories to guide the decision to perform further diagnostic testing, such as D-dimer measurement or CT pulmonary angiography.
How does the Revised Geneva Score differ from the Wells score?
Both are validated PE probability tools, but they use different variables. The Revised Geneva Score is fully objective — all criteria are based on patient history and physical examination findings without requiring physician judgement about alternative diagnoses (except for the 'alternative diagnosis less likely' criterion). The Wells score includes a subjective 'PE most likely diagnosis' criterion worth three points. Studies show both tools have comparable diagnostic performance.
What score threshold separates low from moderate probability?
A total score of 0 to 3 classifies the patient as low probability, with PE prevalence below 15% in validation studies. A score of 4 to 10 indicates moderate probability (15–40% PE prevalence). A score of 11 or above indicates high probability, with PE prevalence exceeding 40%. These thresholds were validated in the original Geneva Score studies and have been replicated across multiple populations.
Can this calculator be used for patients on anticoagulation?
The Revised Geneva Score was validated in unselected patients presenting with suspected PE who were not already anticoagulated for other reasons. Its performance in patients on therapeutic anticoagulation has not been well-studied. Clinical judgement is required in such cases, as anticoagulation may partially suppress symptoms and modify the pre-test probability estimation.
What happens after a high-probability Revised Geneva Score?
A high-probability score (≥11 points) indicates a greater than 40% likelihood of PE and typically warrants immediate CT pulmonary angiography (CTPA) as the definitive diagnostic test, provided the patient's renal function and contrast allergy history allow it. In haemodynamically unstable patients where CTPA is not immediately available, echocardiography and clinical assessment are used. Management follows current ESC or AHA guidelines.
Is the Revised Geneva Score appropriate for paediatric patients?
No. The Revised Geneva Score was validated exclusively in adult populations and is not appropriate for paediatric patients. PE in children is rare and often associated with different risk factors (e.g., central venous catheters, congenital heart disease). Paediatric PE probability assessment requires age-appropriate tools and specialist input from paediatric haematology or cardiology.