title: GRACE risk score as predictor of in-hospital mortality in patients with chest pain.
abstract: BACKGROUND
  Chest pain and chest discomfort are common problems in the acute care setting. Life-threatening causes of chest pain must be quickly differentiated from other less serious causes. There is a need to stratify risk rapidly in patients presenting to the emergency department (ED) with chest pain. This study evaluates the relationship between the GRACE risk score (GRS) and in-hospital mortality in patients presenting to the ED with chest pain of all causes.
  
  
  METHODS
  We conducted a prospective study of a consecutive sample of 1,014 patients with chest pain and chest discomfort presenting to the medical ED of the University Clinic in Giessen, Germany. The GRS was calculated for each patient at admission. Additionally, the reason for admission into the hospital and the diagnosis on discharge or diagnosis of death were recorded. The relative risk between the risk groups was assessed, and the functional dependency between the GRS and observed in-hospital death was analyzed.
  
  
  RESULTS
  A total of 94 patients died during the stay in the hospital, 83 patients with high risk, 9 with medium risk, and 2 with low risk. The risk of in-hospital death was 24.5% for high-risk patients, 2.6% for medium-risk patients, and 0.6% for patients with low risk. The correlation between the GRS and in-hospital mortality is strongly positive (p < 0.01).
  
  
  CONCLUSIONS
  This study shows that the GRS accurately stratifies risk of intra-hospital mortality in patients presenting to the ED with chest pain and can guide patient triage and management.
authors.affiliation: Department of Angiology, University Clinic Giessen, Germany.
authors.forename: Siegbert
authors.initials: S
authors.lastname: Stracke
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.forename: Martin C
authors.initials: MC
authors.lastname: Heidt
authors.forename: Dursun
authors.initials: D
authors.lastname: Gündüz
authors.forename: Christiane
authors.initials: C
authors.lastname: Neuhof
authors.forename: Mariana
authors.initials: M
authors.lastname: Parahuleva
authors.forename: Harald
authors.initials: H
authors.lastname: Tillmanns
authors.forename: Ali
authors.initials: A
authors.lastname: Erdogan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000401:mortality*; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors