Health Dictionary

Overview

The Global Registry of Acute Coronary Events (GRACE) risk score has been developed for the assessment of the risk of death among patients with acute coronary syndrome. There is a GRACE risk score for the estimation of in-hospital mortality and another for mortality in the period from the time of hospital discharge up to 6 months.^[1]^[2]

Grace Risk Score for In-Hospital Mortality

Calculation of Grace Risk Score for In-Hospital Mortality

The total GRACE risk score is calculated by adding the points assigned to the different variable shown below. The highest total possible score 363.^[1]

Variable	Points
Age (years)
<30	0
30–39	8
40–49	25
50–59	41
60–69	58
70–79	75
80–89	91
≥90	100
Heart rate (beats/minute)
<50	0
50–69	3
70–89	9
90–109	15
110–149	24
150–199	38
≥200	46
Systolic blood pressure (mmHg)
<80	58
80–99	53
100–119	43
120–139	34
140–159	24
160–199	10
≥200	0
Initial serum creatinine (mg/dL)
0.0–0.39	1
0.4–0.79	4
0.8–1.19	7
1.2–1.59	10
1.6–1.99	13
0.2–3.99	21
≥4	28
Killip class
I	0
II	20
III	39
IV	59
Cardiac arrest at admission	39
Elevated cardiac markers	14
ST segment deviation	28

Interpretation of Grace Risk Score for In-Hospital Mortality

A nomogram for the probability in-hospital mortality has been developed based on the GRACE score. Shown below is the probability of in-hospital mortality by the corresponding GRACE score value.^[1]

Score	Probability of in-hospital mortality (%)
≤60	≤0.2%
70	0.3%
80	0.4%
90	0.6%
100	0.8%
110	1.1%
120	1.6%
130	2.1%
140	2.9%
150	3.9%
160	5.4%
170	7.3%
180	9.8%
190	13%
200	18%
210	23%
220	29%
230	36%
240	44%
≥250	≥52%

Grace Risk Score for All-Cause Mortality From Discharge to 6 Months

Calculation of the GRACE Score for All-Cause Mortality From Discharge to 6 Months

The total GRACE risk score is calculated by adding the points assigned to the different variable shown below.^[2] The highest total possible score 263.

Variable	Points
Age (years)
<40	0
40–49	18
50–59	36
60–69	55
70–79	73
80–89	91
≥90	100
Heart rate (beats/minute)
≤49.9	0
50–69.9	3
70–89.9	9
90–109.9	14
110–149.9	23
150–199.9	35
≥200	43
Systolic blood pressure (mmHg)
<80	24
80–99.9	22
100–119.9	18
120–139.9	14
140–159.9	10
160–199.9	4
≥200	0
Initial serum creatinine (mg/dL)
0.0–0.39	1
0.4–0.79	3
0.8–1.19	5
1.2–1.59	7
1.6–1.99	9
0.2–3.99	15
≥4	20
History of congestive heart failure	24
History of myocardial infarction	12
Elevated cardiac markers	15
ST segment depression	11
No in-hospital PCI	14

Interpretation of the GRACE Score for All-Cause Mortality From Discharge to 6 Months

References

↑ ^1.0 ^1.1 ^1.2 Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP; et al. (2003). “Predictors of hospital mortality in the global registry of acute coronary events”. Arch Intern Med. 163 (19): 2345–53. doi:10.1001/archinte.163.19.2345. PMID 14581255.
↑ ^2.0 ^2.1 Eagle KA, Lim MJ, Dabbous OH, Pieper KS, Goldberg RJ, Van de Werf F; et al. (2004). “A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry”. JAMA. 291 (22): 2727–33. doi:10.1001/jama.291.22.2727. PMID 15187054. Review in: ACP J Club. 2004 Nov-Dec;141(3):80

Template:WikiDoc Sources

[pmid14581255-1] 1.0 ^1.1 ^1.2 Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP; et al. (2003). “Predictors of hospital mortality in the global registry of acute coronary events”. Arch Intern Med. 163 (19): 2345–53. doi:10.1001/archinte.163.19.2345. PMID 14581255.

[pmid15187054-2] 2.0 ^2.1 Eagle KA, Lim MJ, Dabbous OH, Pieper KS, Goldberg RJ, Van de Werf F; et al. (2004). “A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry”. JAMA. 291 (22): 2727–33. doi:10.1001/jama.291.22.2727. PMID 15187054. Review in: ACP J Club. 2004 Nov-Dec;141(3):80

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