Observational studyArchivos de cardiologia de Mexico2025
Usefulness of the ACTION ICU score to predict complications requiring critical care in Mexican patients with non-ST-segment elevation myocardial infarction.
Observational study in Archivos de cardiologia de Mexico, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe Acute Coronary Treatment and Intervention Outcomes Network Intensive Care Unit (ACTION ICU) score is a tool for assessing the risk of complications associated with non-ST-segment elevation myocardial infarction (NSTEMI) requiring intensive care unit (ICU) admission. The study aimed to describe the usefulness of the ACTION ICU score in Mexican patients with NSTEMI.
methodsA single-center, retrospective, observational, and comparative study of patients with NSTEMI admitted between January 2017 and December 2023; patients with respiratory failure, cardiac arrest, shock, and arrhythmias requiring a pacemaker on admission were excluded from the study. Based on the collected data, the ACTION ICU score was applied to all patients. The cutoff score for ICU admission is 5, with a 9.3% risk of complications. During hospitalization, the composite primary outcome included cardiac arrest, shock, heart block requiring a pacemaker, respiratory failure, stroke, or death. The score's performance was determined by calculating the area under the curve (AUC).
resultsA total of 345 NSTEMI patients were included; 41 (14.2%) developed the primary outcome. The most common complications were shock (12.5%) and respiratory failure (8.1%). A score of 0 to 5 points was present in 187 patients (54.2%), 10 of whom (5.3%) developed the primary outcome. The score had an AUC of 0.77 [CI 0.64-0.97, p value 0.01].
conclusionsThe ACTION ICU score showed acceptable discriminative ability for identifying patients with NSTEMI who need ICU care, providing a valuable tool to predict complications and implement best practices in medical units with limited resources.
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