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Global Registry of Acute Coronary Events (GRACE) risk score

Age (years) years
Heart rate (bpm) bpm
Systolic BP (mm Hg) mm Hg
Creatinine µmols/L
KILLIP Class
Cardiac arrest at admission ?
ST segment deviation ?
Elevated cardiac enzymes ?

Methodology

Granger Model for In-hospital Death
Model estimates from multiple logistic regression model

Intercept-7.7035
AGE (per 1 yr)0.053
PULSE (per 1 BPM)0.0087
SYSTOLIC BLOOD PRESSURE (per 1 mmHG)-0.0168
INITIAL SERUM CREATININE0.1823
KILLIP CLASS (1,2,3, or 4)0.6931
¹CARDIAC ARREST at presentation1.4586
¹INITIAL CARDIAC ENZYME Positive0.4700
¹ST SEGMENT DEVIATION0.8755
¹Enter a value of 1 if factor is present, 0 otherwise.

To obtain estimated risk of death from above estimates. Compute XB, where X=individual patient's value for each factor (eg, age=57, pulse=70…), and B=estimates above, including the intercept.

XB is then the summed product of the patient characteristics times the estimates, with the intercept added for every patient. For example, if a patient is age 57, pulse 70, SBP 110, creatinine 1.2, Killip class III, had cardiac arrest and ST deviation but not initial positive enzymes, XB is:

XB = -7.7035 + 57 x .0531 + 70 x .0087 - 110 x .0168 + 1.2 x .1823 + 3 x .6931 + 1 x 1.4586 + 0 x .47 + 1 x .8755 = -1.28364

The probability of in-hospital death is then

P = ( Exp ^ XB ) / ( 1 + Exp ^ (XB) ) = .21693

Where exp is 2.71828…and ^ means raised to that power (XB power).

© 1998 - 2010, Center for Outcomes Research, University of Massachusetts Medical School