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


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

 
WHO group I subgroup

APAH-CTD (1 point)

APAH-PoPH (2 points)

FPAH (2 points)
Demographics and comorbidity

Renal insufficiency (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
  • 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; BPM: beats per minute; BNP: brain natriuretic peptide; 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; REVEAL: Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension disease management; SBP: systolic blood pressure; PAH: pulmonary arterial hypertension; PVR: pulmonary vascular resistance; 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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