Acute Coronary Syndrome Mortality Calculator for In-Hospital Mortality

Description

Pieper et al updated the GRACE model for predicting in-hospital mortality for a patient who presents with an acute coronary syndrome (ACS). This can help identify patients who may benefit from more aggressive management. The authors are from Global Registry of Acute Coronary Events (GRACE) Investigators.

Patient selection: ACS with or without ST-segment elevation

Parameters:

(1) Killip class (on presentation)

(2) systolic blood pressure in mm Hg (on presentation)

(3) heart rate in beats per minute (on presentation)

(4) age in years

(5) serum creatinine in mg/dL (on presentation)

(6) cardiac arrest at admission

(7) ST-segment deviation

(8) serum cardiac enzyme levels (on presentation)

(9) STEMI

Parameter	Finding	Points
Killip class	I	0
	II	17
	III	34
	IV	51
systolic blood pressure	< 70 mm Hg	66
	70 - 89	53
	90 - 109	40
	110 - 129	27
	>= 130	19
heart rate	< 70 beats per minute	10
	70 - 89	15
	90 - 109	26
	110 - 129	32
	130 - 149	24
	150 - 169	16
	170-199	8
	>= 200	0
age in years	< 30 years of age	0
	30 - 49	10
	50 - 69	29
	70 - 79	56
	80 - 89	73
	>= 90	91
serum creatinine	< 0.40	3
	0.40 - 0.90	9
	1.00 - 1.90	32
	>= 2.00	51
cardiac arrest	no	0
	yes	38
ST-segment deviation	no	0
	yes	18
serum cardiac enzymes	not elevated	0
	elevated	14
STEMI	absent	0
	present	14

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: 1

• maximum score: 375

• The higher the score the greater the probability of in-hospital mortality.

X =

= (0.03304 * (score)) - 7.953

Total Score	Probability of In-Hospital Mortality
< 100	< 1%
100 - 375	1 / (1 + EXP((-1) * X))

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Description

Specialty

Objective

ICD-10

Updated GRACE (Global Registry of Acute Coronary Events) Prediction Model for In-Hospital Mortality for a Patient with Acute Coronary Syndrome

Purpose: To evaluate a patient with an acute coronary syndrome (ACS) for in-hospital mortality using an updated GRACE model.

Description

Specialty

Objective

ICD-10