Echo research and practice
Multi-valvular burden score and one-year mortality in ICU patients undergoing echocardiography: an exploratory cohort study
By Isleyen HB, Yavuz ST, Bulut S and 4 others.
Abstract
Background
Multiple regurgitant lesions coexist in critically ill patients, yet cohort-level analyses typically represent each valve separately. We evaluated whether a Multi-Valvular Burden (MVB) score could summarize regurgitant involvement and whether its prognostic information differed from models retaining individual valve grades.
Methods
This retrospective cohort used MIMIC-IV v3.1 linked with MIMIC-IV-ECHO. Adults with an ICU admission and complete ordinal grading of tricuspid, mitral, and aortic regurgitation on an index echocardiogram within 72 h of ICU admission were included. MVB was the arithmetic sum of TR, MR, and AR grades (0-12). Cox models assessed 1-year all-cause mortality. Additional analyses compared MVB with separate valve-grade models, tested a high-burden definition requiring MVB > = 4 and at least two involved valves, used missing-aware AS/MS evidence proxies, and examined LVEF with structured RV-function classification.