Risk Management

Acute Cardiac Ischemia TIPI (ACI-TIPI)
The Acute Cardiac Ischemia (ACI) - Time Insensitive Predictive Instrument.(TIPI) or ACI-TIPI analyzes a series of variables and calculates the mathematical probability that the patient is experiencing an event of ischemic origin.
The ACI-TIPI is a computerized analysis that incorporates input from a 12 Lead Electrocardiograph findings and patient specific factors to provide a score (from 0% - 100%) that predicts the probability that the patient is having acute cardiac ischemia.
Example: An ACI-TIPI score of greater than 75% likely reflects an established or threatening AMI. Scores less and 75% are less likely, but maybe. Therefore the score must always be considered along with the patient's clinical signs and symptoms.
The ACI-TIPI factors and percentages print directly on the electrocardiogram. Three patient factors (Data Points) are used:

Age Years

Gender Male (M) or Female (F)

Presenting Chest pain status Primary complaint,
Secondary complaint,
None or no chest pain

For more information see:
Systems for Comparing Actual and Predicted Mortality Rates: Characteristics To Promote Cooperation in Improving Hospital Care [PDF]
Use of the Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (ACI-TIPI) To Asist with Triage of Patients with Chest Pain or Other Symptoms Suggestive of Acute Cardiac Ischemia [PDF]
Electrocardiograph-based emergency department risk management tool based on the ACI-TIPI: potential impact on care and malpractice claims [PDF]
Example ACI-TIPI 12-lead ECG Report [PDF]

Thrombolytic Predictive Instrument TIPI (TPI-TIPI)
The Thrombolytic Predictive Instrument (TPI) provides predictions of mortality at one month, and one year within or without treatment with thrombolytic therapy. It will trigger if the 12 Lead Electrocardiograph findings demonstrate ischemia (ST elevation) and additional patient factor information is entered into the machine.
Example: The predictable outcomes, in 0-100%, include:
30 day mortality with Thrombolysis
30 day mortality without Thrombolysis
One year mortality with Thrombolysis
One year mortality without Thrombolysis
Cardiac Arrest within 48 hours
Thrombolysis-related Intracranial Hemorrhage
Thrombolysis-related Other Major Bleeding
The patient factors are:

History of Diabetes Yes or No

History of Hypertension Yes or No

Blood pressure Systolic and Diastolic

Length of time since onset of symptoms Hours and minutes

The TPI factors and percentages print directly on the electrocardiogram.

For more information see:
Patient-Specific Predictions of Outcomes in Myocardial Infarction for Real-Time Emergency Use: A Thrombolytic Predictive Instrument [PDF]
Example PCI-TPI 12-lead ECG Report [PDF]

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