GRACE Calculator
Global Registry of Acute Coronary Events - Assess mortality risk in ACS patients
Patient Assessment Variables
Patient's age in years
Beats per minute
Upper number in blood pressure reading
Kidney function marker
Heart failure classification based on physical examination
Clinical Findings
Select any of the following abnormalities if present:
GRACE Score Results
Mortality Risk
Score Breakdown
Clinical Interpretation
Example Patient Case
Patient Presentation
Age: 72 years
Heart Rate: 85 bpm
Systolic BP: 140 mmHg
Creatinine: 1.2 mg/dL
Killip Class: II (rales present)
ST elevation: Present
Elevated troponin: Present
GRACE Score Calculation
Age (72): 67.3 points
Heart Rate (85): 10.5 points
Systolic BP (140): 29 points
Creatinine (1.2): 8 points
Killip Class II: 20 points
ST deviation: 28 points
Elevated enzymes: 14 points
Total GRACE Score: ~177 (High Risk)
Risk Stratification
Low Risk
GRACE ≤ 108
In-hospital mortality <1%
6-month mortality <3%
Intermediate Risk
GRACE 109-140
In-hospital mortality 1-3%
6-month mortality 3-8%
High Risk
GRACE > 140
In-hospital mortality >3%
6-month mortality >8%
Killip Classification
Class I
No heart failure signs
Class II
Rales, S3 gallop, elevated JVP
Class III
Acute pulmonary edema
Class IV
Cardiogenic shock
Clinical Application
Use on admission for ACS patients
Guides invasive vs conservative strategy
Validates clinical decision-making
Helps with patient counseling
Understanding the GRACE Score
What is GRACE?
The Global Registry of Acute Coronary Events (GRACE) score is a validated clinical tool that estimates the risk of death in patients with acute coronary syndrome (ACS). It helps clinicians make informed decisions about treatment strategies.
Clinical Applications
- •Risk stratification of ACS patients
- •Guiding invasive vs conservative management
- •Patient and family counseling
- •Quality assurance and research
Scoring Variables
8 Key Variables:
- • Age (continuous variable)
- • Heart rate (bpm)
- • Systolic blood pressure (mmHg)
- • Serum creatinine (mg/dL or μmol/L)
- • Killip class (I-IV)
- • Cardiac arrest (yes/no)
- • ST segment deviation (yes/no)
- • Elevated cardiac enzymes (yes/no)
Important: GRACE score helps guide treatment decisions but should always be interpreted in the context of individual patient factors and clinical judgment.
Treatment Recommendations
Low Risk (≤108)
Conservative management may be appropriate. Consider selective invasive strategy based on other factors.
Intermediate Risk (109-140)
Consider early invasive strategy within 24-72 hours. Risk-benefit assessment recommended.
High Risk (>140)
Early invasive strategy strongly recommended within 24 hours. Urgent cardiology consultation.
Related Cardiovascular Risk Calculators
Important Medical Disclaimer
This GRACE calculator is designed for educational purposes and clinical reference only. It should never replace comprehensive clinical assessment or professional medical judgment.
Healthcare professionals should:
- Use GRACE score as part of comprehensive ACS assessment
- Consider individual patient factors beyond the score
- Follow current ACS guidelines (AHA/ACC, ESC)
- Ensure accurate data collection for reliable scoring
- Integrate findings with clinical judgment and other risk tools
This tool is based on the original GRACE registry data and should be used in conjunction with current evidence-based guidelines for acute coronary syndrome management.