Key result
Four prognostic scores similarly predict mortality or HF admission in severe TR.
Why the study?
Four scores were published in 2022 to assess mortality risk in tricuspid regurgitation, prompting the need to externally validate and compare their discriminative ability for mortality and heart failure admission.
Do the TRI-SCORE, Hochstadt, Wang, and TRIO prognostic scores accurately predict mortality and heart failure admission in patients with severe tricuspid regurgitation?
Cohort (n=614)
No
Do the TRI-SCORE, Hochstadt, Wang, and TRIO prognostic scores accurately predict mortality and heart failure admission in patients with severe tricuspid regurgitation?
Effect estimate: C-statistic 0.74 (95% CI 0.70-0.78)
p-value: p=<0.0005
Four recently published prognostic scores for severe tricuspid regurgitation demonstrated similar and significant discriminative ability for predicting mortality and heart failure admissions in an independent external cohort.
May support risk stratification in severe TR; leaves open prospective validation before clinical adoption.
BACKGROUND: Four scores have been published in 2022 for assessing mortality risk of patients with tricuspid regurgitation (TR): the TRI-SCORE, those reported by Hochstadt and Wang and the TRIO score. Our objective was to perform an external validation of available scores for predicting mortality and the combined endpoint of mortality and heart failure (HF) admission, in an independent cohort of patients with severe TR and to compare their discriminative ability. METHODS: Discriminative ability of the scores for predicting events was assessed by means of receiver operating characteristics (ROC) curves. RESULTS: The validation cohort retrospectively included 614 consecutive patients (69 ± 13 years, 72% women) with severe TR studied with echocardiography in a tertiary care hospital and followed for up to 14 years (median 5 years, p25-75 2-7 years), with 358 deaths and 620 HF admissions on follow-up. Discriminative abilities for predicting death (C-statistic .72 [95% CI .68-.76] for the TRI-SCORE; .75 [.71-.78] for the Hochstadt score; .72 [.68-.76] for the Wang score; and .74 [.70-.78] for the TRIO score, p < .0005 for all) or the combined endpoint (C-statistic .74 [.70-.78]; .74 [.70-.78], .73 [.69-.77] and .76 [.72-.80], respectively, p < .0005 for all) on follow-up were statistically significant for all of them. Paired comparisons among them for predicting both endpoints were all non-significant. CONCLUSIONS: All tested scores showed significant and similar discriminative ability for predicting the combined endpoint of mortality or HF admission in this independent validation study of patients with severe TR.
No takes yet. Share an insight, caveat, or question.
Fernández‐Avilés et al. (2025) conducted a cohort in severe tricuspid regurgitation (n=614). Prognostic scores (TRI-SCORE, Hochstadt, Wang, TRIO) was evaluated on Mortality and the combined endpoint of mortality and heart failure (HF) admission (C-statistic 0.74, 95% CI 0.70-0.78, p=<0.0005). Four prognostic scores (TRI-SCORE, Hochstadt, Wang, TRIO) showed similar discriminative ability for predicting mortality or HF admission in severe TR, with C-statistics of 0.73-0.76 (p<0.0005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: