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ACTION ICU Score for Intensive Care in NSTEMI

CardiologyNSTEMIICU triageBeta toolThis tool is in beta. It has undergone internal validation but still requires additional testing. Always confirm the data entered and the results obtained before clinical use. It should not be used as the sole basis for clinical decisions.
The derivation cohort included adults aged 65 years or older; lower ages still calculate but trigger a warning.
years
Signs or symptoms of heart failure on admissionPresence adds 5 points.
Scored as <85, 85-99, or >=100 bpm.
bpm
Scored as >=145, 125-144, or <125 mmHg.
mmHg
Use the local assay multiple of the ULN; >=12 x ULN adds 2 points.
x ULN
Values >=1.1 mg/dL add 1 point.
mg/dL
Prior coronary revascularizationAbsence of prior revascularization adds 1 point.
Chronic lung diseasePresence adds 2 points.
ST-segment depression on the initial ECGPresence adds 1 point.

Clinical noticeEducational triage aid only. Do not replace individualized clinical assessment or local ICU-admission policy with this score alone.

Context and use

ACTION ICU = age (>=70:1) + creatinine (>=1.1:1) + heart rate (85-99:1; >=100:3) + systolic BP (125-144:1; <125:3) + troponin (>=12 x ULN:2) + heart failure (5) + ST depression (1) + no prior revascularization (1) + chronic lung disease (2)

Predicted risk: <=1 = 3.4%, 2 = 4.9%, 3 = 5.5%, 4 = 6.9%, 5 = 9.3%, 6 = 12.0%, 7 = 14.6%, 8 = 17.4%, 9 = 20.8%, 10 = 23.3%, 11 = 27.7%, 12 = 31.0%, 13 = 31.5%, 14 = 39.3%, >14 = 39.3% with the approved ceiling warning.

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