TIMI Score for STEMI Calculator
The TIMI score for STEMI calculator (Thrombolysis In Myocardial Infarction for ST-segment Elevation Myocardial Infarction) is an easy to use bedside tool to distinguish patients who are at most risk of a fatal outcome in the thirty-day follow-up. TIMI for STEMI risk score is a twin version of the TIMI score, which we use in unstable angina and non-ST-segment elevation myocardial infarct. It uses basic parameters and clinical assessment, among which just one - Killip class - serves as a single, strong predictor of mortality, which raises the scale's reliability even more.
We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. If any health condition bothers you, consult a physician.
When and why to use TIMI score for STEMI calculator?
Chest pain is one of the most common complaints on admission to the hospital. It can have dozens of causes, but if the patient seeks professional emergency help, it often turns out to be myocardial infarction. The diagnosis is severe and requires immediate, advanced medical help. Unfortunately, even the right treatment (like PCI - percutaneous coronary intervention) doesn't make all the risks go away. An injured heart needs time to recover. That's why the time right after admission and even after treatment is crucial - a patient is monitored continuously for a couple of days.
Among the group of already-at-high-risk-of-death patients, discriminating the most endangered persons and putting them under close observation in steadily monitored rooms or intensive care units can save their lives.
That's why the TIMI for STEMI Score was created. Developed in 2000 by Morrow et al. for patients with diagnosed STEMI (not just chest pains), it has been validated numerous times since then, and the results were always favorable. It is also simple to use - an evaluation shouldn't take more than a couple of minutes, especially if you have access to the patient's monitored data. Being such an easily applicable bedside tool that can save a patient's life, the TIMI STEMI risk score has become standard practice.
Using TIMI Score for STEMI
Using our calculator is as simple as it seems and can make your work a bit easier. Just pick the age range from the drop-down list box and then select "Yes" next to the criteria that refers to your patient. If you hover the mouse cursor over a single predictor, you'll see more detailed information. If you need more help, move to the section on the criteria below.
You'll see the result as soon as you fill in the final field. As it says, the result applies to mortality in general, not to, e.g., a direct complication of the myocardial infarction.
Thanks to our TIMI score for STEMI calculator, you don't have to remember the number values of each criterion anymore!
TIMI for STEMI risk score criteria
The TIMI STEMI risk score consists of eight different criteria. Some of the predictors (criteria) are simple critical parameters; some are more complex and require further evaluation of the patient. All of them have different weights according to the adjusted odds ratios from logistic regression analysis - as in the original paper.
In TIMI score, we'll find:
- Age (2 or 3 points) - and we set apart two thresholds here, 65 and 75 years old.
- Diabetes, angina pectoris or hypertension (1 point) - these are all risk factors for coronary artery disease (CAD) and overall mortality.
- Heart rate over 100 beats per minute (2 points) - normal resting heart rate ranges from 60 to 100 beats per minute, and if it's higher it usually indicates that heart function is deteriorating.
- Killip class II-IV (2 points) - requires a thorough physical examination of the patient, we use it to evaluate the heart failure grade - find out more in the paragraph dedicated to Killip class.
- Systolic blood pressure <100mmHg (3 points) - hypertension is a predictors of mortality as well. Still, low arterial blood pressure might mean that not enough oxygen is reaching to the body's tissues.
- Anterior lead ST elevation or left bundle branch block (1 point) - this TIMI STEMI score serves patients with ST-elevation myocardial infarction. The new left bundle branch block (LBBB) was considered to be an ECG infarction phenomenon for a long time, but now it's role has been diminished, and it is recommended to use the Sgarbossa Criteria while assessing the ECG record.
- Time to treatment >4 hours (1 point).
- Body weight less than 150lbs (appr. <67kg) (1 point) - it was proven that low body weight correlates with increased mortality.
Killip class - close-up
Killip classification (sometimes called Killip-Kimball class) is a four-degree system used to evaluate the severity of heart failure in patients with acute myocardial infarction and enables us to assess the risk of death in the following month.
The scale is relatively old (first introduced in 1967), but was validated even in the 21st century, and the results state that the class is still a powerful predictor. It also shows the importance of the physical examination, which we sometimes forget about among all the modern equipment and digital parameters.
The table below shows the Killip classes. In TIMI score for STEMI calculator classes II-IV worsen the prognosis.
|Clinical sings||Killip class||30-day mortality|
|Rales or crackles in the lungs, S3 (third heart sound), elevated jugular veins pressure||II||5 - 12%|
|Acute pulmonary edema||III||10 - 20%|
|Cardiogenic shock, [hypotension (SBP <90mmHg)](calc:587), oliguria, sweating, cyanosis||IV||10 - 20%|