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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
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    Patent Pending

    ACTION ICU Score for Intensive Care in NSTEMI

    Predicts risk of NSTEMI complications requiring ICU care.
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    IMPORTANT

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

    INSTRUCTIONS

    Use in emergency patients with NSTEMI.

    When to Use
    Pearls/Pitfalls
    Why Use

    • Emergency patients with NSTEMI, to predict likelihood of complications requiring ICU care for patients with NSTEMI.

    • Should not be used in patients with STEMI, cardiogenic shock, or cardiac arrest.

    • Derived in patients ≥65 years old, and may not apply to younger patients.

    • Different institutions may use different thresholds for ICU admission.

    • Not yet prospectively validated.

    Helps identify patients who are initially stable but may later develop complications requiring a higher level of care, and may therefore help with disposition and avoiding failure to rescue.

    <70
    0
    ≥70
    +1
    <1.1
    0
    ≥1.1
    +1
    <85
    0
    85-100
    +1
    ≥100
    +3
    ≥145
    0
    125-145
    +1
    <125
    +3
    <12
    0
    ≥12
    +2
    No
    0
    Yes
    +5
    No
    0
    Yes
    +1
    Yes
    0
    No
    +1
    No
    0
    Yes
    +2

    Result:

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    Next Steps
    Evidence
    Creator Insights

    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.

    Content Contributors
    About the Creator
    Dr. Alexander C. Fanaroff
    Content Contributors