🫀 ACTION-ICU Score (NSTEMI ICU Need)
UseWhen to use: hemodynamically stable NSTEMI at admission when deciding ward vs ICU/CCU.
StrataHigher scores tracked higher complication risk in ACTION Registry derivation; low score does not forbid ICU i…
LimitsWhen not to use: STEMI, shock, or arrest on arrival (derivation exclu… · Pitfall: using a single cut-off without considering ongoing ischemia … · Local CCU capacity and pathways matter as much as the score.
SourceChina ACS / NSTE-ACS guidance on zh when cited
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Published Fanaroff points 0–19.
When to use
When to use: hemodynamically stable NSTEMI at admission when deciding ward vs ICU/CCU.
How it works
Age≥70 (1) + Cr≥1.1 (1) + HR (<85=0, 85–100=1, ≥100=3) + SBP (≥145=0, 125–145=1, <125=3) + trop≥12×ULN (2) + HF signs (5) + ST depression (1) + no prior revasc (1) + chronic lung disease (2). Range 0–19.
Key points
- Published Fanaroff points 0–19.
- Common threshold discussion around >5.
- Next: GRACE / Killip / local ACS pathway.
References
- [Guideline / primary source]China ACS / NSTE-ACS guidance on zh when cited
- Fanaroff AC, et al. J Am Heart Assoc 2018 (ACTION-ICU)
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | < 70 y (0) |
|---|---|
| Serum creatinine | < 1.1 mg/dL (0) |
| Heart rate | 85–100 /min (1) |
| Systolic BP | 125–145 mmHg (1) |
| Initial troponin × ULN | < 12× ULN (0) |
| Signs/symptoms of heart failure | No (0) |
| ST-segment depression | No (0) |
| Prior revascularization | Yes (0) |
| Chronic lung disease | No (0) |
→ACTION-ICU2/19
- Band：Lower risk — many systems use ≤5 for non-ICU if no other ICU indication
- Common threshold：Score >5 often favors ICU; set local cutoffs
| Age | < 70 y (0) |
|---|---|
| Serum creatinine | < 1.1 mg/dL (0) |
| Heart rate | < 85 /min (0) |
| Systolic BP | ≥ 145 mmHg (0) |
| Initial troponin × ULN | < 12× ULN (0) |
| Signs/symptoms of heart failure | No (0) |
| ST-segment depression | No (0) |
| Prior revascularization | Yes (0) |
| Chronic lung disease | No (0) |
→ACTION-ICU0/19
- Band：Very low complication band in derivation
- Common threshold：Score >5 often favors ICU; set local cutoffs
Verification & sources · governance
FAQ
Frequently asked questions
- Does ACTION-ICU Score (NSTEMI ICU Need) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is ACTION-ICU Score (NSTEMI ICU Need) calculated in practice? Can you show a worked example?
- Inputs: Age < 70 y (0), Serum creatinine < 1.1 mg/dL (0), Heart rate 85–100 /min (1), Systolic BP 125–145 mmHg (1), Initial troponin × ULN < 12× ULN (0), Signs/symptoms of heart failure No (0), ST-segment depression No (0), Prior revascularization Yes (0)… → Result: ACTION-ICU 2 /19（Band: Lower risk — many systems use ≤5 for non-ICU if no other ICU indication, Common threshold: Score >5 often favors ICU; set local cutoffs） Inputs: Age < 70 y (0), Serum creatinine < 1.1 mg/dL (0), Heart rate < 85 /min (0), Systolic BP ≥ 145 mmHg (0), Initial troponin × ULN < 12× ULN (0), Signs/symptoms of heart failure No (0), ST-segment depression No (0), Prior revascularization Yes (0)… → Result: ACTION-ICU 0 /19（Band: Very low complication band in derivation, Common threshold: Score >5 often favors ICU; set local cutoffs）