A modified risk score in one-year survival rate assessment of group 1 pulmonary arterial hypertension

BACKGROUND: Risk assessment of pulmonary arterial hypertension (PAH) contributes to its management. Unfortunately, the existing risk assessment approaches are defective for clinicians to practice in daily clinical settings to some extent. METHODS: We designed a modified Risk Assessment Score of PAH (mRASP) comprising four non-invasive variables which were World Health Organization functional class(WHO FC), 6-min walk distance (6MWD), N-terminal of the pro-hormone brain natriuretic peptide(NT-pro BNP), and right atrial area(RAA), then validated it in the prediction of one-year survival rate for patients with PAH by contrast with the REVEAL risk score. RESULTS: For the validation cohort(n = 216), the predicted one-year survival rate were 95–100%, 90–95%, and < 90% in the mRASP risk score strata of 0–2, 3–5, and 6–8, respectively; meanwhile, the observed one-year survival rates were 97.1, 92.6, and 52.2%, in each corresponding stratum, respectively. The mRASP (c-index = 0.727) demonstrated similar predictive power in contrast with the REVEAL risk assessment score (c-index = 0.715) in the prediction of one-year survival rate. CONCLUSION: The mRASP is an eligible risk assessment tool for the prognostic assessment of PAH. In contrast with the REVEAL score, it demonstrated similar predictive power and accuracy, with extra simplicity and convenience.