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Calculator: REVEAL pulmonary arterial hypertension (PAH) score and estimated 1 year survival for adult patients with PAH (group 1)


 Calculator: REVEAL pulmonary arterial hypertension (PAH) score and estimated 1 year survival for adult patients with PAH (group 1)

 
PAH subgroup

APAH-CTD (1 point)

 APAH-PoPH (2 points)

 FPAH (2 points)

 Other (0 points)
Demographics and comorbidity

 Kidney function impairment (1 point)

 Male age >60 years old (2 points)
NYHA/WHO functional class

Class I (-2 points)

 Class II (0 points)

 Class III (1 point)

 Class IV (2 points)
Vital signs

 SBP <110 mmHg (1 point)

 HR >92 BPM (1 point)
6 minute walk test

≥440 m (-1 point)

 165 to 439 m (0 points)

 <165 m (1 point)
Blood chemistry

BNP <50 pg/mL or N-terminal proBNP <300 pg/mL (-2 points)

 BNP 50 to 180 pg/mL or N-terminal proBNP 300 to 1500 pg/mL (0 points)

 BNP >180 pg/mL or N-terminal proBNP >1500 pg/mL (1 point)
Echocardiography

 Pericardial effusion present (1 point)
Pulmonary function testing

DLCO ≥80% predicted (-1 point)

 DLCO 33 to 79% predicted (0 points)

 DLCO ≤32% predicted (1 point)
Right heart catheterization

 mRAP >20 mmHg within 1 year (1 point)

 PVR >32 Wood units [>2560 dynes-sec/cm5] (2 points)

 
Important: Inputs must be complete to perform calculation.

 
Total criteria point count:
 

 

 REVEAL PAH score interpretation

 
0 to 7 points: Low risk with 95 to 100% estimated 1 year survival
8 points: Average risk with 90 to <95% estimated 1 year survival
9 points: Moderately high risk with 85 to <90% estimated 1 year survival
10 to 11 points: High risk with 70 to <85% estimated 1 year survival
12 to 22 points: Very high risk with <70% estimated 1 year survival

 
Notes
  • This calculator only applies to patients with PAH (group 1). It does not apply to patients with group 2, 3, 4, or 5 PH. For further information on the classification of PH, refer to UpToDate topics on the diagnosis and treatment of PH.
  • The baseline score is 6 points, but this may be reduced to 0 by criteria with negative point values. The maximum score is 22.
  • This risk score calculates survival only and should not be used to make decisions for treatment.
  • APAH-CTD: associated pulmonary arterial hypertension with connective tissue disease; APAH-PoPH: associated pulmonary arterial hypertension with portopulmonary hypertension; BNP: brain natriuretic peptide; BPM: beats per minute; DLCO: diffusing capacity of lung for carbon monoxide; FPAH: familial pulmonary arterial hypertension; HR: heart rate; mRAP: mean right arterial pressure; NYHA: New York Heart Association; PH: pulmonary hypertension; PVR: pulmonary vascular resistance; REVEAL: Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension disease management; SBP: systolic blood pressure; WHO: World Health Organization.

 
Only digits 0 to 9 and a single decimal point (".") are acceptable as numeric inputs. Attempted input of other characters into a numeric field may lead to an incorrect result.

Information on this page may not appear correctly if printed.

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All information contained in and produced by the EBMcalc system is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER.

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