MDCalc

ACTION ICU Score for Intensive Care in NSTEMI

Predicts risk of NSTEMI complications requiring ICU care.

This calculator is not externally validated, and as such, should be used with caution.

Use in emergency patients with NSTEMI.

Age, years
Serum creatinine, mg/dL
Heart rate, bpm
Systolic blood pressure, mmHg
Ratio of initial troponin to upper limit of normal
Signs or symptoms of heart failure
ST segment depression on EKG
Prior revascularization
Chronic lung disease

Result:

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Advice

  • Patients with low risk for complications requiring ICU care may be considered for admission outside of an ICU setting.

  • Patients with high risk for complications requiring ICU care may benefit from early admission to the ICU.

Management

  • Hospital systems should define their own threshold for ICU admission, based on ICU capacity, non-ICU resource availability, etc.

  • For example, an ACTION ICU threshold of 5 might triage 50% of patients to the ICU, with an expected complication rate of <10% for non-ICU patients, while an ACTION ICU threshold of 12 might triage 50% of only very high risk patients to the ICU.

Critical Actions

This predictive tool should not replace clinical judgment. Not all factors benefiting from ICU care can be accounted for in this score.

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