Comparison of Wells and Revised Geneva Scores in Patients with Computed Tomography Pulmonary Angiographyconfirmed Pulmonary Thromboembolism: A Cross-sectional Study

Introduction: Pulmonary Thromboembolism (PTE) is the third most common acute cardiovascular condition globally, following myocardial infarction and stroke. Clinical Decision Tools (CDTs) such as the Wells score and the revised Geneva score assist in risk stratification for suspected PTE. While widely validated in Western populations, data from India are scarce. Aim: To compare the Wells and revised Geneva CDTs in patients with Computed Tomography Pulmonary Angiography (CTPA) confirmed PTE. Materials and Methods: This single-centre, cross-sectional study was conducted in the Department of General Medicine, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India, from April 2023 to April 2024. A total of 100 patients aged >18 years with CTPA-confirmed PTE were included. Detailed clinical history, co-morbidities, recent surgery or immobilisation, and systemic examination findings were recorded. Both Wells and revised Geneva scores were applied. Statistical analysis was performed using Epi Info version 7, and a p-value 50 years; 56% were males. Breathlessness was the most common presenting symptom and immobilisation >three days was the most prevalent risk factor. Deep Vein Thrombosis (DVT) was observed in 56% of patients. Based on Wells score: 16% were low-risk, 34% intermediate, and 50% high-risk. According to the revised Geneva score: 0% was low-risk, 34% intermediate, and 56% high-risk. Considering “intermediate or high probability” as positive, the Wells score had a sensitivity of 84%, while the revised Geneva score showed a higher sensitivity of 100%. All patients had D-dimer levels >500 ng/mL. Conclusion: Both Wells and revised Geneva scores demonstrated a significant association with PTE, validating their applicability in the Indian setting. The revised Geneva score had higher sensitivity than Wells score, but cannot be considered superior in diagnostic accuracy, as the study design included only confirmed PTE cases. D-dimer remains a highly sensitive screening tool in the diagnosis of PTE.