title: Importance of Wells score and Geneva score for the evaluation of patients suspected of pulmonary embolism.
abstract: OBJECTIVE
  The European Society of Cardiology guidelines for pulmonary embolism (PE) published in 2008 and updated in 2014 recommend a risk stratification including risk scores like Wells and the Geneva score. The utility and practicability of these scores are controversially discussed. Recently, in a trauma cohort and in spinal surgery patients, no correlation between Wells Score and PE diagnosis was found. The aim of the study was the evaluation of Wells and Geneva scores in patients presenting with chest pain, dyspnoea or syncope in an emergency department.
  
  
  METHODS
  We retrospectively examined 326 patients suspected of PE, including assessment, according to Wells and Geneva scores.
  
  
  RESULTS
  PE was detected in 13.5 %. The average Wells score was 1.0, the average Geneva score 3.9. The receiver operating characteristic (ROC) curve analyses showed for both scores a high significant area under the curve (Wells score 0.68; Geneva score 0.64). The association between the scores and the diagnosis of PE was calculated with logistic regression analysis and showed high significant odds ratios (OR) for both scores (Wells score 1.38; Geneva score 1.24). There was no significant difference between the area under the curve (AUC) of Wells score and Geneva score.
  
  
  CONCLUSIONS
  The utility of Wells and Geneva scores for the evaluation of patients suspected of PE in an emergency patient cohort.
authors: Emergency Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany joachim.gruettner@umm.de.
authors: Joachim
authors: J
authors: Gruettner
authors: Emergency Department, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Thomas
authors: T
authors: Walter
authors: First Department of Medicine (Cardiology), University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Siegfried
authors: S
authors: Lang
authors: Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Michael
authors: M
authors: Meyer
authors: Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Paul
authors: P
authors: Apfaltrer
authors: Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Thomas
authors: T
authors: Henzler
authors: Clinic for Anaesthesiology and Operative Intensive Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Tim
authors: T
authors: Viergutz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D004636:Emergency Service, Hospital; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011655:Pulmonary Embolism / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: Geneva score; Pulmonary embolism; Wells score; emergency department