GRACE Score (in-hospital mortality)

Compute the simplified GRACE (Global Registry of Acute Coronary Events) score for risk stratification in non-ST-elevation acute coronary syndromes.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Age
70 years
Heart rate
95 bpm
Systolic BP
115 mmHg
Creatinine
1.2 mg/dL
Killip class
1

Result: GRACE 143: high risk (>3% in-hospital mortality).

The tool opens with these values already filled in. Replace them with your own.

What the result means

<=108
Low risk: roughly under 1% predicted in-hospital mortality.
109-140
Intermediate risk: roughly 1-3% predicted in-hospital mortality.
>140
High risk: roughly over 3% predicted in-hospital mortality.

What you enter

  • Age
  • Heart rate
  • Systolic BP
  • Creatinine
  • Killip class
  • Cardiac arrest at admission
  • ST-segment deviation
  • Abnormal cardiac enzymes

What this is

Inputs are age, heart rate, systolic blood pressure, creatinine, Killip class (clinical heart-failure category), cardiac arrest on arrival, ST-segment deviation on the presenting ECG, and elevated cardiac biomarkers. Sophie Well sums the published point values and returns the total along with the in-hospital and six-month all-cause mortality bands from the GRACE Project derivation cohort.

When to use it

Use this on an NSTE-ACS patient in the ED or chest-pain unit to choose between an early-invasive strategy (cath within 24 hours, recommended for intermediate- and high-risk GRACE bands) and an ischemia-guided strategy. GRACE is the strongest validated risk score for this purpose and is referenced explicitly in current ACC/AHA and ESC NSTE-ACS guidelines. It is not appropriate for STEMI (where immediate reperfusion supersedes risk scoring) and should not be used to triage non-ACS chest pain - use HEART for that population.

How this is calculated

Granger CB, et al. GRACE Project. Arch Intern Med. 2003;163(19):2345-2353. Simplified-points implementation. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

More in Cardiology.

Browse all tools

Built by Clay Good. Source on GitHub.