PUBLIC LIBRARY / CALCULATOR

GRACE score (in-hospital mortality)

Estimates in-hospital mortality risk across the full spectrum of acute coronary syndrome using 8 admission variables; in non-ST-elevation ACS it guides the timing of an invasive strategy.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

GRACE/Granger 2003: in-hospital nomogram, local interpolation; not GRACE 2.0

The 2003 GRACE estimates death during hospitalization across the spectrum of acute coronary syndrome. The original nomographic version and local interpolation are not the GRACE 2.0 model. Decisions on invasive strategy, other time horizons or risk rates require the corresponding guideline and edition.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Age · years
Heart rate · bpm
Systolic blood pressure · mmHg
Creatinine · mg/dL
Killip class
Cardiac arrest at admission
ST-segment deviation
Elevated necrosis markers (troponin/CK-MB)

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Nomogram points (Granger 2003): age < 30 = 0, 30–39 = 8, 40–49 = 25, 50–59 = 41, 60–69 = 58, 70–79 = 75, 80–89 = 91, ≥ 90 = 100 · HR < 50 = 0, 50–69 = 3, 70–89 = 9, 90–109 = 15, 110–149 = 24, 150–199 = 38, ≥ 200 = 46 · SBP < 80 = 58, 80–99 = 53, 100–119 = 43, 120–139 = 34, 140–159 = 24, 160–199 = 10, ≥ 200 = 0 · creatinine (mg/dL) < 0.4 = 1, 0.4–0.79 = 4, 0.8–1.19 = 7, 1.2–1.59 = 10, 1.6–1.99 = 13, 2–3.99 = 21, ≥ 4 = 28 · Killip I = 0, II = 20, III = 39, IV = 59 · cardiac arrest = 39 · ST deviation = 28 · elevated markers = 14.

The probability of death is read from the nomogram (interpolated between the tabulated points).

References

Identifier: grace

Original clinical content: Brazilian Portuguese.

Method version

GRACE/Granger 2003: in-hospital nomogram, local interpolation; not GRACE 2.0

grace@native-2026-10-05+a6c377609dab

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Age: 55 years
Heart rate: 80 bpm
Systolic blood pressure: 130 mmHg
Creatinine: 1 mg/dL
Killip class: I
Elevated necrosis markers (troponin/CK-MB): Yes
Cardiac arrest at admission: No
ST-segment deviation: No

{
  "idade": 55,
  "fc": 80,
  "pas": 130,
  "cr": 1,
  "killip": "1",
  "enz": true,
  "pcr": false,
  "st": false
}

Expected result

{
  "score": 105,
  "level": "low"
}

Actual result

{
  "score": 105,
  "prob": 0.9500000000000001
}

Case 2

reference-002

Inputs

Age: 65 years
Heart rate: 72 bpm
Systolic blood pressure: 145 mmHg
Creatinine: 0.9 mg/dL
Killip class: I
ST-segment deviation: Yes
Elevated necrosis markers (troponin/CK-MB): Yes
Cardiac arrest at admission: No

{
  "idade": 65,
  "fc": 72,
  "pas": 145,
  "cr": 0.9,
  "killip": "1",
  "st": true,
  "enz": true,
  "pcr": false
}

Expected result

{
  "prob": 2.9
}

Actual result

{
  "score": 140,
  "prob": 2.9
}

Case 3

reference-003

Inputs

Age: 72 years
Heart rate: 95 bpm
Systolic blood pressure: 125 mmHg
Creatinine: 1.3 mg/dL
Killip class: II
ST-segment deviation: Yes
Elevated necrosis markers (troponin/CK-MB): Yes
Cardiac arrest at admission: No

{
  "idade": 72,
  "fc": 95,
  "pas": 125,
  "cr": 1.3,
  "killip": "2",
  "st": true,
  "enz": true,
  "pcr": false
}

Expected result

{
  "prob": 16
}

Actual result

{
  "score": 196,
  "prob": 16
}

Case 4

reference-004

Inputs

Age: 85 years
Heart rate: 120 bpm
Systolic blood pressure: 85 mmHg
Creatinine: 2.5 mg/dL
Killip class: IV
Cardiac arrest at admission: Yes
ST-segment deviation: Yes
Elevated necrosis markers (troponin/CK-MB): Yes

{
  "idade": 85,
  "fc": 120,
  "pas": 85,
  "cr": 2.5,
  "killip": "4",
  "pcr": true,
  "st": true,
  "enz": true
}

Expected result

{
  "prob": 52
}

Actual result

{
  "score": 329,
  "prob": 52
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

README

Local installation

Code license: Apache-2.0

Guidelines and conditions

This repository’s license applies to the code. Third-party instruments, questionnaires, data and models remain subject to their owners’ conditions.

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.