The POISE score significantly predicted raised pulmonary capillary wedge pressure (C-statistic 0.72; 95% CI 0.65-0.78), outperforming both OPTICS and H2FPEF scores in an Asian cohort.
Cohort
No
Does the POISE score accurately predict postcapillary pulmonary hypertension in an Asian population compared to OPTICS and H2FPEF scores?
The novel POISE score offers high specificity for noninvasively predicting postcapillary pulmonary hypertension in Asian patients, potentially reducing the need for right heart catheterization.
Odds Ratio: 2.07 (95% CI 1.13–3.78)
BACKGROUND: Noninvasive prediction of postcapillary pulmonary hypertension (PH) is a useful clinical tool. However, existing scores are not well evaluated in Asian populations. OBJECTIVES: This study aimed to develop a novel prediction score for postcapillary PH in an Asian cohort. METHODS: A single-center retrospective cohort study was performed in patients who had undergone right heart catheterization from July 2018 to June 2022. Patients with an ejection fraction 20 mm Hg and pulmonary capillary wedge pressure (PCWP) >15 mm Hg. A novel logistic regression model (POISE Prediction Of raISEd wedge pressures) was developed, with validation by bootstrapping. Comparisons against the OPTICS and H2FPEF scores were performed. Sensitivity analysis was performed excluding patients with combined pre- and post-PH. RESULTS: (adjusted OR: 2.07; 95% CI: 1.13-3.78) were significant predictors of raised PCWP (C-statistic: 0.72; 95% CI: 0.65-0.78). At a chosen cutoff of ≥0.72, POISE had a specificity of 97.4% (95% CI: 95.0%-99.9%) and sensitivity of 10% (95% CI: 4.4%-15.6%). Internal validation and sensitivity analysis excluding patients with combined pre- and post-PH revealed C-statistics of 0.70 (95% CI: 0.70-0.79) and 0.75 (95% CI: 0.67-0.81), respectively, outperforming both OPTICS and H2FPEF scores. CONCLUSIONS: The high specificity and better performance (vis à vis existing scores) of POISE may help in identifying a subset of Asian patients with postcapillary PH, reducing the need of right heart catheterization. POISE is available as an online risk calculator.
Jiang et al. (Fri,) conducted a cohort in Postcapillary pulmonary hypertension. POISE score vs. OPTICS and H2FPEF scores was evaluated on Raised pulmonary capillary wedge pressure (postcapillary PH) (OR 2.07, 95% CI 1.13-3.78). The POISE score significantly predicted raised pulmonary capillary wedge pressure (C-statistic 0.72; 95% CI 0.65-0.78), outperforming both OPTICS and H2FPEF scores in an Asian cohort.
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