A comparison of the Wells and revised Geneva scores for diagnosing pulmonary thromboembolism in the emergency room

Abstract

Introduction: pulmonary thromboembolism (PTE) is a potentially fatal condition that must be diagnosed promptly. The Wells and revised Geneva scores are tools used to estimate the pretest probability of this disease. However, their comparative performance at a local level has not been clearly established.

Methods: a diagnostic test study was conducted comparing the Wells and revised Geneva scores for estimating the pretest probability of PTE in the emergency room of a quaternary care hospital in Bogotá. Patients over the age of 18 who were seen for suspected PTE during 2023 and had enough information to apply both scores were included.

Results: a total of 41 patients were enrolled; 68% were female and 36% were over the age of 65. None of the patients were classified as high risk on either of the scales. The Wells score had a sensitivity of 77.4% and a specificity of 10%, while the revised Geneva score had a sensitivity of 85.7% and a specificity of 25%.

Conclusions: this study compared the Wells and revised Geneva scores for diagnosing PTE in the emergency room, finding complementary clinical usefulness depending on the patient’s profile and the diagnostic goal. We highlight the need to continue evaluating their performance in specific populations like oncological or critically ill patients