2022 ESC/ERS Baseline Risk Score Calculator

The 2022 ESC/ERS Treatment Guidelines¹ recommend using 3-strata risk stratification at baseline. A clinician's best judgment should be used when scoring the multi-parameter variables.

At least 3 variables must be selected to recieve a risk score.

Signs of right HF Absent Absent Present 0

Progression of symptoms No
  Slow
  Rapid
  0
 

Syncope No Occasional syncope Repeated syncope 0

WHO-FC I, II III IV 0

6MWD >440 m 165-440 m <165 m 0

CPET
   
Peak VO₂ >15mL/min/kg
(>65% pred.)
VE/VCO₂ slope <36 Peak VO₂11-15mL/min/kg
(35-65% pred.)
VE/VCO₂ slope 36-44 Peak VO₂ <11mL/min/kg
(<35% pred.)
VE/VCO₂ slope >44
0
   

Biomarkers: BNP or
NT-proBNP BNP < 50ng/L
NT-proBNP <300ng/L BNP 50-800ng/L
NT-proBNP 300-1100ng/L BNP >800ng/L
NT-proBNP >1100ng/L 0
 

 
Echocardiography
  
  RA area <18 cm²
TAPSE/sPAP >0.32 mm/mmHg
No Pericardial Effusion
  RA area 18-26 cm²
TAPSE/sPAP 0.19-0.32 mm/mmHg
Minimal Pericardial
Effusion RA area >26 cm²
TAPSE/sPAP <0.19 mm/mmHg
Moderate-large Pericardial Effusion
 
0
  
 

cMRI
    RVEF >54%
SVI >40 mL/m²
RVESVI <42 mL/m² RVEF 37-54%
SVI 26-40 mL/m²
RVESVI 42-54 mL/m² RVEF <37%
SVI >26 mL/m²
RVESVI >54 mL/m²
0
   

Hemodynamics
  
    RAP <8 mm Hg
CI ≥2.5 L/min/m²
SVI >38 mL/m²
SvO₂ >65% RAP 8-14 mm Hg
CI 2-2.4 L/min/m²
SVI 31-38 mL/m²
SvO₂ 60-65% RAP >14 mm Hg
CI <2 L/min/m²
SVI <31 mL/m²
SvO₂ <60%
0
   
  

Total Risk Score
  Divide the sum of all variable scores by the number of variables entered and round to the nearest decimal
 
 

  Low Risk
1 to <1.5 Intermediate Risk
1.5 to <2.5 High Risk
2.5 to 3  
 

The parameters and thresholds in the above table are taken from the 2022 ESC/ERS Guidelines for PAH¹. The scoring methodology (1=low risk, 2=intermediate risk, 3=high risk) was adapted from the Swedish PAH Registry^2,3.

 

References: 1. Humbert M, et al. Eur Heart J. 2022;43(38):3618-3731. 2. Kylhammar D, et al. Eur Heart J. 2018;39(47):4175-4181. 3. Hoeper MM, et al. Eur Respir J. 2017;50(2). pii:1700740

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