Wicki et al developed a simple clinical score to help identify patients with a pulmonary embolism in the Emergency Department. The authors are from Geneva University Hospital in Switzerland.
Parameters:
(1) age of the patient in years
(2) history of pulmonary embolus (PE) or deep vein thrombosis (DVT)
(3) history of recent surgery (within past 4 weeks)
(4) pulse in beats per minute
(5) PaCO2 in kPa
(6) PaO2 in kPa
(7) chest X-ray showing plate-like atelectasis
(8) chest X-ray showing elevation of the hemidiaphragm
|
Parameter |
Finding |
Points |
|---|---|---|
|
age of the patient |
< 60 years |
0 |
|
|
60–79 years |
1 |
|
|
>= 80 years |
2 |
|
history of PE or DVT |
no |
0 |
|
|
yes |
2 |
|
history of recent surgery |
no |
0 |
|
|
yes |
3 |
|
pulse rate |
> 100 beats per minute |
1 |
|
|
<= 100 beats per minute |
0 |
|
PaCO2 |
< 4.8 kPa |
2 |
|
|
4.8–5.19 kPa |
1 |
|
|
>= 5.2 kPa |
0 |
|
PaO2 |
< 6.5 kPa |
4 |
|
|
6.5–7.99 kPa |
3 |
|
|
8.00–9.49 kPa |
2 |
|
|
9.5–10.99 kPa |
1 |
|
|
>= 11.0 kPa |
0 |
|
plate-like atelectasis on chest X-ray |
no |
0 |
|
|
yes |
1 |
|
elevation of hemidiaphragm on chest X-ray |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the more likely a pulmonary embolus is present.
|
Total Score |
Probability of Pulmonary Embolus |
|
0–4 |
low (5–15%) |
|
5–8 |
intermediate (22–55%) |
|
9–11 |
high (76–85%) |
|
12–16 |
certain (100%) |
Purpose: To evaluate a patient in the Emergency Department for the likelihood of a pulmonary embolus using the Geneva score of Wicki et al.
Specialty: Pulmonology
Objective: risk factors, criteria for diagnosis, severity, prognosis, stage, complications
ICD-10: I26,
