Fernández-Avilés Consuelo, Ruiz Ortiz Martín, Fernández Ruiz Ana, Heredia Campos Gloria, Resúa Collazo Adriana, González-Manzanares Rafael, Delgado Ortega Mónica, Rodríguez Almodóvar Ana, Esteban Martínez Fátima, Maestre Luque Luis Carlos, Morán Salinas Alberto, Torres Zamudio Alberto, Herrera Flores Javier, Díaz Andrade Manuel, López Aguilera José, Anguita Sánchez Manuel, Pan Álvarez-Osorio Manuel, Mesa Rubio Dolores
Cardiology Department, University Hospital Reina Sofia, Córdoba, Spain.
Maimonides Institute for Biomedical Research of Córdoba, IMIBIC, Córdoba, Spain.
Eur J Clin Invest. 2025 Mar;55(3):e14379. doi: 10.1111/eci.14379. Epub 2025 Jan 10.
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.
Discriminative ability of the scores for predicting events was assessed by means of receiver operating characteristics (ROC) curves.
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.
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.
2022年已发表了四项用于评估三尖瓣反流（TR）患者死亡风险的评分：TRI-SCORE、Hochstadt和Wang报告的评分以及TRIO评分。我们的目的是在一个独立的重度TR患者队列中对现有的预测死亡率以及死亡率和心力衰竭（HF）住院的联合终点的评分进行外部验证，并比较它们的判别能力。
通过受试者操作特征（ROC）曲线评估评分对预测事件的判别能力。
验证队列回顾性纳入了一家三级护理医院中614例连续的重度TR患者（69±13岁，72%为女性），这些患者接受了超声心动图检查，并随访了长达14年（中位数5年，第25-75百分位数为2-7年），随访期间有358例死亡和620例HF住院。所有评分对预测随访期间死亡（TRI-SCORE的C统计量为0.72[95%CI 0.68-0.76]；Hochstadt评分的C统计量为0.75[0.71-0.78]；Wang评分的C统计量为0.72[0.68-0.76]；TRIO评分的C统计量为0.74[0.70-0.78]，所有p<0.0005）或联合终点（C统计量分别为0.74[0.70-0.78]；0.74[0.70-0.78]、0.73[0.69-0.77]和0.76[0.72-0.80]，所有p<0.0005）的判别能力均具有统计学意义。它们之间在预测两个终点方面的配对比较均无统计学意义。
在这项对重度TR患者的独立验证研究中，所有测试评分在预测死亡率或HF住院的联合终点方面均显示出显著且相似的判别能力。
