Abstract: ob＜x＞jective The clinical applications of two adult pulmonary hypertension risk stratification scales recommended by Chinese guidelines for diagnosis and treatment of Pulmonary Hypertension 2018 and Chinese guidelines for diagnosis and treatment of Pulmonary Hypertension (2021 Edition) were compared in the real world. Method The clinical data of 127 patients with PAH treated in the affiliated Hospital of Xuzhou Medical University and the first affiliated Hospital of Chongqing Medical University from January 2016 to February 2021 were collected. The risk stratification and prognosis of the patients were compared with the risk stratification scale recommended by the above two guidelines. Compare 1. The difference between the two kinds of risk stratification results in clinical ba＜x＞seline data; 2. The difference in the number of cases with different risk stratification after stratification according to the two risk stratification scales; 3. The differences in predicting 1-year survival rate and 5-year survival rate after different risk stratification were compared. Results A total of 127 patients were included, including 21 males (16.5%) and 106 females (83.5%), with a median age of 38.0 (27.5-51.0) years. There was no significant difference in WHO cardiac function classification, echocardiographic indexes, brain natriuretic peptide, and hemodynamic indexes between the low, middle, and high-risk groups of version 2018 and version 2021. There was no difference in the distribution of the number of cases according to different risk stratification scales. The follow-up period was up to March 30, 2022, and the median follow-up time was 30.6 months. The survival curve showed that the 1-year survival rates of the low, medium, and high-risk groups in version 2018 and low, medium, and high-risk groups in version 2021 were consistent with the predicted risk of death. 5-year survival rate: according to the 2018 version of the risk stratification scale, there was no significant difference in survival rate among low, medium, and high-risk groups(P > 0.05). According to the 2021 version of the risk stratification scale, there was a significant difference in survival rate among low, middle, and high-risk groups(P < 0.05). Conclusion The results of analysis ba＜x＞sed on this group of data showed no significant difference in risk assessment of ba＜x＞seline data of PAH patients between version 2018 and version 2021 of the risk stratification scale. There was no significant difference in 1-year survival rate between the two risk stratification methods. According to the 2021 version of the risk stratification scale, the 5-year survival curve of patients in low, medium, and high-risk groups was consistent with the predicted results of risk stratification.