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Emergency Medicine & Critical CareRevised Geneva Score

Revised Geneva Score Calculator for Pulmonary Embolism

Calculate original and simplified Revised Geneva pretest-probability scores for adult suspected PE from direct age, pulse and explicit source findings.

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One adult suspected-PE record; two independently weighted models. Every raw finding must be assessed. [1, 2]

Use only for an adult with clinically suspected acute PE when this pretest-probability assessment has been selected. Not screening. Do not delay resuscitation or urgent diagnostic evaluation for a score. This calculator does not establish whether D-dimer or imaging is appropriate.

About

This Revised Geneva Score calculator returns two independently calculated pretest-probability models from one adult suspected-PE record: the original revised model of Le Gal 2006 and the simplified revised model of Klok 2008. These use eight standardized clinical variables without the Wells clinician-judgment item. This is not the pre-2006 original Geneva score. [1, 2]

Neither result diagnoses or excludes PE alone. The appropriate diagnostic pathway combines clinical pretest probability with the applicable D-dimer strategy, imaging and clinical context. Confirmed-PE prognosis is a different task. [3]

Formula

Original Revised Geneva = sum of eight Le Gal 2006 weighted criteria (0–22).
Simplified Revised Geneva = independent sum of Klok 2008 weights (0–9); heart rate ≥95 contributes 2 total points.

Interpretation

Published clinical pretest-probability classes

Original 2006: 0–3 Low; 4–10 Intermediate; ≥11 High. [1]

Simplified 2008 three-level: 0–1 Low; 2–4 Intermediate; ≥5 High (including 8 and 9). Two-level: 0–2 PE unlikely; ≥3 PE likely. “PE unlikely” does not mean excluded, and “PE likely” does not mean confirmed. [2, 6]

The weights and cutoffs differ. Do not average, cross-convert or reconcile the two outputs into a combined Geneva risk level.

Eight source variables, two independent weight systems

Original and simplified Revised Geneva weights
Source criterionOriginalSimplified
Age >65 years11
Previous DVT or PE31
Surgery under GA OR lower-limb fracture within the past month2 once1 once
Active malignant condition21
Unilateral lower-limb pain31
Hemoptysis21
Heart rate <75 / 75–94 / ≥95 beats/min0 / 3 / 50 / 1 / 2
Deep venous palpation pain AND unilateral edema41

Absent criteria score zero. Age must be greater than 65: 65 scores zero and 66 scores one. Heart-rate bands include 75 and 94 together; 95 enters the upper band. All raw subcomponents must be assessed. Surgery/fracture is OR, without double-counting; palpation pain plus unilateral edema is AND. Unilateral pain remains its own item. [1, 2]

Maximum proof: original 1 + 3 + 2 + 2 + 3 + 2 + 5 + 4 = 22; simplified 1 + 1 + 1 + 1 + 1 + 1 + 2 + 1 = 9. Source malignancy means solid or hematologic cancer currently active or considered cured for less than one year; surgery means general anesthesia within the past month, not a substituted Wells definition or an invented 30-day rule. [2]

Why simplified heart rate ≥95 is two points

The Klok 2008 primary model gives the higher heart-rate band an additional point beyond the first heart-rate point: ≥95 bpm contributes 2 total simplified heart-rate points. The 2019 ESC Table 5 also presents 2. [2, 6]

The 2026 AHA/ACC Table 3 rendering lists the simplified ≥95-bpm row differently and displays simplified ranges ending at 7. QuickMedCalc follows the primary simplified-model publication, not that differing display: valid totals reach 9. [2, 3]

The July Circulation and August 11, 2026 JACC corrections update Table 4 and its echocardiography reference; they do not amend Revised Geneva Table 3. This is a documented presentation discrepancy, not a new Geneva model. [4, 5]

What the validation studies found

In Le Gal 2006’s external validation cohort, PE prevalence was 8% in Low, 28% in Intermediate and 74% in High categories. These are historical validation-cohort prevalences, not this user’s individual probability. [1]

Klok 2008 combined 1,049 patients from two prospective diagnostic trials, with overall VTE prevalence 23%. AUC was 0.75 (95% CI 0.71–0.78) for the original revised score and 0.74 (0.70–0.77) for the simplified score. [2]

No VTE occurred during three-month follow-up in the studied combinations of a normal highly sensitive D-dimer with low/intermediate simplified probability or with PE-unlikely simplified probability. This was a combined diagnostic strategy, not score-alone exclusion. [2]

Revised Geneva vs Wells, PERC and YEARS

Wells PE includes the judgment that PE is more likely than another diagnosis, uses HR >100, and has a different surgery/immobilization construct. Revised Geneva uses standardized source findings, age and HR bands, separate unilateral pain and compound palpation-plus-edema evidence. They are alternatives, not interchangeable or cross-convertible models. [3, 6]

A Low Geneva category does not automatically establish PERC eligibility. PERC has its own sufficiently-low-pretest-probability applicability requirement. YEARS separately combines its three criteria with a D-dimer algorithm; this page does not run either tool. [3, 6]

Revised Geneva is a PE pretest score, not a DVT diagnostic or prophylaxis score. Previous DVT is a predictor, not the target diagnosis. Wells DVT, Padua and Caprini are separate tasks. PESI/Bova/CPES address confirmed-PE severity or prognosis; Hestia addresses confirmed-PE outpatient exclusions.

Current guideline role and pregnancy boundary

The 2026 AHA/ACC guideline identifies Wells, Revised Geneva and PERC as commonly used pretest-probability tools; Figure 1 includes revised Geneva among validated tools. A score alone does not determine D-dimer, CTPA, anticoagulation, admission or treatment. Assay, age/clinical-probability adjustment, imaging strategy and patient context remain separate. [3]

This calculator reproduces standard adult models, not a pregnancy-adapted Geneva model. Pregnancy requires an applicable pregnancy-specific diagnostic protocol; research using revised Geneva or pregnancy-adapted YEARS does not create trimester-specific weights here. Do not delay urgent evaluation or resuscitation for this online score. [3]

References

  1. 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. PMID 16461960. DOI 10.7326/0003-4819-144-3-200602070-00004.
  2. Klok FA, Mos ICM, Nijkeuter M, et al. Simplification of the Revised Geneva Score for Assessing Clinical Probability of Pulmonary Embolism. Arch Intern Med. 2008;168(19):2131–2136. PMID 18955643. DOI 10.1001/archinte.168.19.2131.
  3. Creager MA, Barnes GD, Giri J, et al. 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults. Circulation. 2026;153:e977–e1051. Figure 1 and Table 3. PMID 41712677. DOI 10.1161/CIR.0000000000001415.
  4. Creager MA, Barnes GD, Giri J, et al. Correction to the 2026 Acute Pulmonary Embolism Guideline. Circulation. 2026;154(2):e24. PMID 42441758. DOI 10.1161/CIR.0000000000001462. Updates Table 4 and its reference, not Geneva Table 3.
  5. Correction to the 2026 Acute Pulmonary Embolism Guideline. J Am Coll Cardiol. 2026 Aug 11;88(6):713. DOI 10.1016/j.jacc.2026.06.033. Updates Table 4 and its reference, not Geneva Table 3.
  6. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the ERS. Eur Heart J. 2020;41(4):543–603. Table 5. DOI 10.1093/eurheartj/ehz405.

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Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.