Validity of GRACE Risk score to predict in- hospital mortality of acute coronary syndrome in CCU of ALYarmouk teaching hospital

Abstract

Background: Patients with acute coronary syndrome (ACS) are liable to death during their
hospitalization or thereafter. The Global Registry of Acute Coronary Events (GRACE) score is a
simple tool that can predict mortality .
Objective: To predict the probability of in hospital death and also guides the appropriate treatment
plan in acute coronary syndrome at the time of hospital admission.
Patients and methods
 150 patients with ACS admitted to Al- Yarmouk teaching hospital, Coronary Care Unit(CCU) from
1
st of July 2017to 31th of January 2018, were included in this cross-sectional study, those with
symptoms and signs compatible with ACS, by applying GRACE score which uses readily identifiable
clinical parameters like :
cardiac arrest on admission, age of the patient ,heart rate, systolic blood pressure, Killip class,
laboratory parameters like serum creatinine , elevated cardiac markers, and ST segment elevation. with
follow up of patients during period of hospitalization.
Results
 Among 150 patients which presented in this study , 90 patients (60%) was male and 60 (40%) was
female.
Patients were classified according to GRS, 30 patients (20%) were in low risk category, 55
patients(37%) were in intermediate risk category, 65patients(43%) were in high risk category. Out of
150 patients enrolled in the study, 26(8.5%) died during the period of admission, all of them in the
moderate and large risk groups, There were significant difference in age, SBP and HR between the
three risk groups of the study (Low, Intermediate, High) according to Grace score.
Conclusions
 Grace score is an easy method and an excellent tool to stratify patients and can prediction of inhospital mortality for ACS patients and useful indicator to reinforce urgent intervention among high
risk individuals to decrease mortality and complications during CCU admission.