GRACE Calculator

Score the eight GRACE predictors — age, heart rate, systolic blood pressure, creatinine, Killip class, cardiac arrest, ST-segment deviation, and biomarker status — to estimate in-hospital mortality risk after acute coronary syndrome.

Quick Facts

Score components
8 predictors, 0-372 points
Age, heart rate, systolic BP, and creatinine use range-based point tables; Killip class, cardiac arrest, ST deviation, and biomarkers add fixed points.
In-hospital risk bands
Low ≤108 · Intermediate 109-140 · High >140
Corresponding to roughly <1%, 1-3%, and >3% in-hospital mortality in the original registry.

Your Results

Calculated
GRACE score
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Total points
Vitals & labs subtotal
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Age + heart rate + SBP + creatinine
Clinical findings subtotal
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Killip + arrest + ST deviation + biomarkers
Est. in-hospital mortality
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Original registry risk band

Ready

Enter the eight GRACE predictors, then calculate the score.

About the GRACE score

The GRACE (Global Registry of Acute Coronary Events) risk score is a validated bedside tool for estimating in-hospital mortality in patients presenting with acute coronary syndrome — ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, or unstable angina. Derived from the international GRACE registry and published in 2003, it remains one of the most widely used ACS risk models, recommended alongside clinical judgment in cardiology guidelines for early risk stratification.

How the score is built

The GRACE score sums points from eight variables measured at presentation:

  • Age: points rise in bands from 0 for under 30 years to 100 for 90 years and older.
  • Heart rate: points rise from 0 below 50 bpm to 46 at 200 bpm or above.
  • Systolic blood pressure: points fall as pressure rises — 58 points below 80 mmHg down to 0 points at 200 mmHg or above.
  • Serum creatinine: points rise from 1 below 0.40 mg/dL to 28 at 4.00 mg/dL or above.
  • Killip class: a four-level measure of heart failure signs, worth 0 points for Class I (no failure) up to 59 points for Class IV (cardiogenic shock).
  • Cardiac arrest at admission: adds 39 points if present.
  • ST-segment deviation on the ECG: adds 28 points if present.
  • Elevated cardiac biomarkers (such as troponin above the local upper limit): adds 14 points if present.

Adding the eight components gives a total that typically falls between about 1 and 372 points.

Interpreting the result

In the original derivation cohort, a total score of 108 or below is low risk, with roughly 1% in-hospital mortality; 109 to 140 is intermediate risk, with roughly 1-3% mortality; and above 140 is high risk, with mortality above 3%. Higher scores reflect more physiological derangement at presentation and, on average, worse in-hospital outcomes.

When to consult a professional

This tool performs the standard GRACE point arithmetic for education and reference. It is not a diagnosis and does not replace clinical judgment. Anyone with symptoms of a possible heart attack should seek emergency medical care immediately; risk-stratification decisions should always rest with the treating clinical team.

Frequently Asked Questions

What is the GRACE score and what does it predict?
The GRACE (Global Registry of Acute Coronary Events) risk score is a point-based tool that estimates in-hospital mortality risk for patients with acute coronary syndrome (STEMI, NSTEMI, or unstable angina). It sums points from eight independent predictors measured at presentation. The total score, which typically ranges from about 1 to 372, is grouped into low, intermediate, and high risk bands.
What are the eight variables in the GRACE score?
The eight predictors are age, heart rate, systolic blood pressure, serum creatinine, Killip class (a four-level measure of heart failure signs), cardiac arrest at admission, ST-segment deviation on the ECG, and elevated cardiac biomarkers such as troponin. Each is converted to points using a fixed table and the points are added together.
How is the GRACE score interpreted?
In the original derivation, a score of 108 or below is low risk with roughly 1 percent in-hospital mortality, 109 to 140 is intermediate risk with roughly 1 to 3 percent mortality, and above 140 is high risk with mortality above 3 percent. These are population-level estimates from the GRACE registry, not an individual prognosis, and should be interpreted by a clinician alongside the full clinical picture.

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