What question did this study set out to answer?

The study aims to validate the Ramathibodi PSVT recurrence score and develop a more accurate local prediction model.

March 9, 2026Open Access

External validation of the Ramathibodi paroxysmal supraventricular tachycardia recurrence score and development of a refined prediction model in a Hong Kong emergency department adult cohort: A retrospective study

Key Result

A refined PSVT recurrence score in Hong Kong adults improved prediction accuracy to AUC 0.827 vs 0.782 for the original, with recurrence rates from 1.1% to 80% by score.

Key Points

The study aims to validate the Ramathibodi PSVT recurrence score and develop a more accurate local prediction model.
Conducted a retrospective cohort study at Tseung Kwan O Hospital ED.
Included adults with PSVT treated with up to 3 adenosine doses.
Assessed score performance using area under the receiver operating characteristic curve (AUC).
Used univariable and multivariable logistic regression to identify predictors for a new score.
Out of 278 patients, 42 (15.1%) experienced recurrence.
Original score had an AUC of 0.782, indicating moderate predictive ability.
Refined score achieved an AUC of 0.827, demonstrating improved discrimination.
Predicted recurrence rates were consistent with observed rates across different scores.

Structured PICO

Does a refined prediction model improve the prediction of 24-hour PSVT recurrence compared to the Ramathibodi score in adult ED patients treated with adenosine?

Population

278 adults (≥18 years) with paroxysmal supraventricular tachycardia (PSVT) treated with ≤3 adenosine doses in a Hong Kong emergency department

Intervention

Refined PSVT recurrence prediction score (incorporating postconversion heart rate >100 bpm, ≥2 adenosine doses, hypertension, and ischemic heart disease)

Comparator

Original Ramathibodi PSVT recurrence score

Outcome

24-hour PSVT recurrencehard clinical

A refined 5-point clinical score using postconversion heart rate, adenosine doses, hypertension, and ischemic heart disease accurately predicts 24-hour PSVT recurrence in the emergency department.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Background Paroxysmal supraventricular tachycardia (PSVT) recurrence after adenosine treatment is common in emergency departments (EDs), but predictive tools require validation. Objectives To externally validate the Ramathibodi PSVT recurrence score in a Hong Kong ED cohort and develop a refined local model for predicting 24‐h recurrence. Methods This retrospective cohort study included adults (≥18 years) with PSVT treated with ≤3 adenosine doses at Tseung Kwan O Hospital ED (July 2020–June 2025). Data were extracted from electronic records. The original score's performance was assessed via area under the receiver operating characteristic curve (AUC). Univariable and multivariable logistic regression identified predictors for a new score. Results Of 278 patients, 42 (15.1%) had recurrence. The original score had AUC 0.782 (95% CI 0.706–0.858), with good calibration ( p = 0.539). A new score (postconversion heart rate >100 bpm: 1 point; ≥2 adenosine doses: 2 points; hypertension: 1 point; and ischemic heart disease: 1 point; total 0–5) achieved AUC 0.827 (95% CI 0.764–0.891). Observed recurrence rates aligned with predictions (e.g., score 0: 1.1% and score 5: 80.0%). Conclusions The Ramathibodi score performed moderately in this cohort. The refined score offers improved discrimination, aiding ED risk stratification.