GRACE ACS score 2.0 ước tính nguy cơ tử vong cho bệnh nhân hội chứng vành cấp và định hướng thời điểm can thiệp xâm lấn.

Công thức tính điểm GRACE (6 tháng)

Điểm GRACE 6 tháng = Tổng các điểm thành phần từ 8 yếu tố (Age + Heart rate + Systolic BP + Creatinine + Killip class + Cardiac arrest + ST deviation + Elevated cardiac enzymes)

Trong đó:

1. Age (Tuổi): Tính theo năm. Điểm được tính theo công thức từng khoảng tuổi:
   • <35 tuổi: 0 điểm
   • 35–45: Round((Tuổi – 35) × 1.8)
   • 45–55: 18 + Round((Tuổi – 45) × 1.8)
   • 55–65: 36 + Round((Tuổi – 55) × 1.8)
   • 65–75: 54 + Round((Tuổi – 65) × 1.9)
   • 75–85: 73 + Round((Tuổi – 75) × 1.8)
   • 85–90: 91 + Round((Tuổi – 85) × 1.8)
   • ≥90: 100 điểm
2. Heart rate (Nhịp tim): Tính theo bpm (lần/phút).
   • <70: 0 điểm
   • 70–80: Round((Nhịp tim – 70) × 0.3)
   • 80–90: 3 + Round((Nhịp tim – 80) × 0.2)
   • 90–100: 5 + Round((Nhịp tim – 90) × 0.3)
   • 100–110: 8 + Round((Nhịp tim – 100) × 0.2)
   • 110–150: 10 + Round((Nhịp tim – 110) × 0.3)
   • 150–200: 22 + Round((Nhịp tim – 150) × 0.3)
   • ≥200: 34 điểm
3. Systolic BP (Huyết áp tâm thu): Tính theo mmHg.
   • <80: 40 điểm
   • 80–100: Round(40 – (BP – 80) × 0.3)
   • 100–110: Round(34 – (BP – 100) × 0.3)
   • 110–120: Round(31 – (BP – 110) × 0.4)
   • 120–130: Round(27 – (BP – 120) × 0.3)
   • 130–140: Round(24 – (BP – 130) × 0.3)
   • 140–150: Round(20 – (BP – 140) × 0.4)
   • 150–160: Round(17 – (BP – 150) × 0.3)
   • 160–180: Round(14 – (BP – 160) × 0.3)
   • 180–200: Round(8 – (BP – 180) × 0.4)
   • ≥200: 0 điểm
4. Creatinine (Creatinin huyết thanh): Tính theo mg/dL, sử dụng bảng chi tiết (từ 0.2 đến ≥4.0 mg/dL) với công thức từng đoạn tuyến tính (như trong code hiện tại).
5. Killip class:
   • Class I: 0 điểm
   • Class II: 15 điểm
   • Class III: 29 điểm
   • Class IV: 44 điểm
6. Cardiac arrest at admission (Ngừng tim khi nhập viện): Có = 30 điểm, Không = 0 điểm
7. ST segment deviation (ST chênh lệch trên ECG): Có = 17 điểm, Không = 0 điểm
8. Elevated cardiac enzymes (Men tim tăng): Có = 13 điểm, Không = 0 điểm

Nguồn: Fox KA et al. (GRACE 2.0 model) và Omni Calculator implementation.

PHÂN LOẠI NGUY CƠ

TÀI LIỆU THAM KHẢO

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