Geneva Score
The Geneva Score (also known as the Geneva Score ) is a scoring system used to determine the likelihood of a pulmonary embolism . In contrast to the Wells Score, where one criterion is: "There is no other diagnosis that is more likely than a pulmonary embolism" , the Geneva Score explicitly made sure that all criteria can be objectified.
Revised Geneva Score
To evaluate the original Geneva score, an arterial blood gas analysis is required, in which the patient should breathe room air. As this was often not available, the revised Geneva Score was created. This is based on eight criteria which can be evaluated by taking a medical history and a simple examination of the patient.
This has been simplified because in the acute setting the risk of calculation errors is increased due to the different values of the criteria.
| Symptoms / observations | Points original | Points simplified |
|---|---|---|
| Age> 65 years | 1 | 1 |
| Previous deep vein thrombosis or pulmonary embolism (PE) | 3 | 1 |
| Surgery or fracture within the last month | 2 | 1 |
| Active neoplasia | 2 | 1 |
| Unilateral leg pain | 3 | 1 |
| painful palpation of deep leg veins and unilateral leg edema | 4th | 1 |
| bloody expectoration | 2 | 1 |
Heart rate :
|
3 5 |
1 2 |
| evaluation | ||
| two-stage score | ||
| LE unlikely | 0-4 points | 0-1 point |
| LE likely | ≥ 5 points | ≥ 2 points |
| three-stage score | ||
| low probability of PE | 0-3 points | - |
| mean probability of a LE | 4-10 points | - |
| high probability of a LE | ≥ 11 points | - |
Original Geneva score
In order to improve and simplify the diagnosis of pulmonary embolism, Wicki et al. the original Geneva score. The aim was a simple, standardized, clinical score to classify emergency patients with suspected pulmonary embolism into different risk groups. The original Geneva Score is based on the assessment of eight criteria that have a significant association with pulmonary embolism.
| Symptoms / observations | Points |
|---|---|
Age
|
1 2 |
| Previous deep vein thrombosis or pulmonary embolism | 2 |
| Surgery in the past 4 weeks | 3 |
| Heart rate> 100 / min | 1 |
CO 2 partial pressure
|
2 1 |
O 2 partial pressure
|
4 3 2 1 |
| Plates atelectasis in chest X-ray | 1 |
| unilateral elevation of the diaphragm in the chest x-ray | 1 |
| evaluation | |
| low probability of PE | ≤4 |
| mean probability of a LE | 5-8 |
| high probability of a LE | ≥9 |
Web links
- S2k guideline for diagnosis and therapy of venous thrombosis and pulmonary embolism of the Dt. Society for Angiology - Society for Vascular Medicine. In: AWMF online (as of October 10, 2015)
- Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A: Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score . In: Archives of Internal Medicine . tape 161 , no. 1 , January 8, 2001, p. 92-7 , doi : 10.1001 / archinte.161.1.92 , PMID 11146703 .
Individual evidence
- ^ Le Gal, G: Prediction of Pulmonary Embolism in the Emergency Department: The Revised Geneva Score . In: Annals of Internal Medicine . tape 144 , no. 3 , February 7, 2006, p. 165–171 , doi : 10.7326 / 0003-4819-144-3-200602070-00004 ( annals.org [accessed April 5, 2016]).
- ^ Klok, A: Simplification of the Revised Geneva Score for Assessing Clinical Probability of Pulmonary Embolism . In: Arch Intern Med . tape 168 , no. 19 , October 27, 2008, p. 2131-2136 , doi : 10.1001 / archinte.168.19.2131 ( jamanetwork.com [accessed April 5, 2016]).
- ^ Wicki, J et al .: Assessing Clinical Probability of Pulmonary Embolism in the Emergency Ward - A Simple Score . In: Arch Intern Med . tape 161 , no. 1 , January 2001, p. 92-97 , doi : 10.1001 / archinte.161.1.92 ( jamanetwork.com [accessed April 5, 2016]).