Abstract 13428: Validation of the Tri-Score for Outcome Prediction After Isolated Tricuspid Valve Surgery in Asians

Introduction: TRI-SCORE was recently developed in Europe as a risk model for predicting in-hospital mortality after isolated tricuspid valve surgery (ITVS).

Hypothesis: This study aimed to validate TRI-SCORE in an Asian population and investigate its value for predicting long-term outcomes.

Methods: The TRI-SCORE was calculated for 186 patients (65 ± 12 years, 62% female, 88% functional tricuspid regurgitation [TR]) who underwent ITVS for severe TR at two Korean centers and was based on eight parameters: age, New York Heart Association class, right-sided heart failure signs, furosemide daily dose, glomerular filtration rate, bilirubin, left ventricular ejection fraction, and moderate/severe right ventricular dysfunction. The primary outcome was all-cause death during follow-up; the secondary outcome was in-hospital mortality.

Results: During a median follow-up duration of 50 months after ITVS (interquartile range 22-82), 21 patients (11.3%) experienced the primary outcome, and six patients (3.2%) experienced the secondary outcome. Observed all-cause death and in-hospital mortality increased by up to 50% in those with higher scores. Patients with the primary outcome had a higher TRI-SCORE (4.4 ± 2.5 vs. 2.9 ± 2.1, p = 0.003) than those without. The TRI-SCORE showed a significant association with the primary outcome (concordance index: 0.76, cut-off value: 4) and in-hospital mortality (concordance index 0.84, cut-off value: 5) (Figure). Using the Kaplan-Meier analysis, patients with a high TRI-SCORE exhibited a poor clinical outcome for all-cause death at follow-up (log-rank p = 0.001) and in-hospital mortality (log-rank p = 0.003).

Conclusions: TRI-SCORE was validated in an Asian population and helped predict long-term outcomes after ITVS.