Congruency between clinician‐assessed risk and calculated risk of 1‐year mortality in patients with pulmonary arterial hypertension: A retrospective chart review
Abstract The objective of this analysis was to compare clinician‐based and formally calculated risk assessments by REVEAL Lite 2 and COMPERA 2.0 and to characterize parenteral prostacyclin utilization within 90 days of baseline in high‐risk patients. A multisite, double‐blind, retrospective chart re...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-10-01
|
| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12455 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract The objective of this analysis was to compare clinician‐based and formally calculated risk assessments by REVEAL Lite 2 and COMPERA 2.0 and to characterize parenteral prostacyclin utilization within 90 days of baseline in high‐risk patients. A multisite, double‐blind, retrospective chart review of patients with pulmonary arterial hypertension (PAH) was conducted with an index period of January 2014–March 2017. Patients were categorized into the “any PAH medication” or “prostacyclin‐enriched” cohort based on latest PAH medication initiated within the index period. Clinicians classified the patient's 1‐year mortality risk as “low,” “intermediate,” or “high” based on their clinical assessment. REVEAL Lite 2 and COMPERA 2.0 scores were independently calculated. Risk assessment congruency was evaluated. Parenteral prostacyclin use was evaluated within 90 days of baseline. Thirty‐two clinicians participated and abstracted data for 299 patients with PAH. At baseline, mean patient age was 52 years, 6‐min walk distance was 226 m, and most patients were WHO functional class II or III. Half of the patients (53%) were classified by clinician assessment as intermediate risk, while most were classified as high risk by REVEAL Lite 2 (59%) and intermediate‐high risk by COMPERA 2.0 (52%). Parenteral prostascyclins were underutilized in high‐risk patients, and not initiated in a timely fashion. Clinician‐assessed risk category was incongruent with tool‐based risk assessments in 40%–54% of patients with PAH, suggesting an underestimation of the patient's risk category by clinician gestalt. Additionally, there was a lack of timely prostacyclin initiation for patients with PAH stratified as high‐risk by either tool. |
|---|---|
| ISSN: | 2045-8940 |