APACHE Acute Diagnoses: Difference between revisions

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''This is not about [[Chronic Health APACHE]] or the [[APACHE Comorbid Diagnoses]].
{{Reporting Indicators
|description =This is about the disease category  which is  one of the components in the model of predicting hospital mortality.  The other components of the model are the [[APACHE Score]] and the presence or absence of [[Emergency Surgery (concept)]].


The [[APACHE Acute Diagnoses]] are a subset of our [[Admit Diagnosis]] or [[Acquired Diagnosis]].  
This is not about [[Chronic Health APACHE]] or the [[APACHE Comorbid Diagnoses]].
{{DA | There would be no way to exclude post-first-48hr Acquireds from the calculation. Do we care? Or should this only be Admits? }}
| indicator_name = ICU Diagnostic Categories by APACHE II
| created_raw = Created 
| program = Critical Care
| indicator_start_date = Oct 2016
| indicator_end_date =
}}
== How to Determine the Diagnosis Category For each Patient ==
*Each disease category or diagnosis leading to ICU admission has an associated weight in the model and varies for non-operative and post-operative patients.
** Post-operative patients are those with [[Previous Location]] either Operating Room or Recovery Room.
*There are weights for specific diagnosis categories and for major organ systems. The specific diagnosis category leading to ICU admission will first be determined based on the priority list in the descending order of the weights and if found none, then the major organ system  following the priority list also in descending order will be used instead.
**For non-operative patients, there are 24 specific diagnosis categories while 18 for post-operative patients; total of 42 which are shown in the [[S_ICD10_APACHE_Dx_patterns table]].
**There are 5  major vital organ system  for both non-operative and post-operative patients (e.g. Nuerological, Cardiovascular, Respiratory, Gastrointestinal, Metabolic/renal)  and all others NOS.
*The diagnosis having the highest weight is assigned to the patient.
*The 42 diagnosis categories are further grouped into eight major diagnostic categories for reporting purposes namely:
** Respiratory Disorders, Cardiac Disease, Post Cardiac Arrest, Neurologic Disorders,
** Trauma and Poisoning, Post-Operative Care, Metabolic/Renal/GI/Hypovolemic Shock, Sepsis and Septic Shock
*** The 8 major categories are included  in [[S_ICD10_APACHE_Dx_patterns table]].


{{DA | [[Diabetes_mellitus_chronic_complication:_Musculoskeletal]]
== ICD10 Mapping of Diagnosis Category ==
is selected by the line
*Before Jan 2019, Drs. Carla Chrusch and  Kendiss Olafson did the mapping of the old admit diagnosis coding to the diagnosis categories included in the model.
* ns_Z1 Renal/Metabolic NOS NOT admitted to ICU postoperatively AND Any admit diagnosis is N00.^-N39.^, E00.^-E90.^
*Starting Jan 2019, Dr. Allan Garland did the mapping of the admit ICD10 codes and CCI codes to the diagnosis categories included in the model.
In your excel sheet.
**The list of admit diagnosis ICD10 codes is shown in [[APACHE Acute Dxs in ICD10 codes]]
 
It is a chronic code sort of by definition, so hopefully no one would code it as an admit, but for now they ''could''. And if they did, it would give them APACHE Dx (not como) points.
 
Is that really as intended? I suppose even as a chronic code it is a marker for the presence of diabetes, so it wouldn’t necessarily be wrong, but it seems odd, so flagging it.}}
{{DT | need here some general info what these are, links to wiki articles they are actually related to under old coding scheme, etc. I need help with this because I don't know if any of this is on the wiki, or else what it is about. Ttenbergen 17:20, 2018 February 23 (CST)}}


== Implementation in CCMDB ==
== Implementation in CCMDB ==
Line 23: Line 34:
The contents of the  
The contents of the  
* [[S_ICD10_APACHE_Dx query]]
* [[S_ICD10_APACHE_Dx query]]
are then used by the  
are then used by the  
* [[L_ICD10_APACHE_Dx query]]
* [[L_ICD10_APACHE_Dx query]]
to provide the list of ICD10 APACHE Acute Diagnoses for patient records.  
to provide the list of ICD10 APACHE Acute Diagnoses for patient records.


== further on this wiki ==
For a list of these diagnoses on this wiki, see
* [[APACHE Acute Dxs in ICD10 codes]]
* [[APACHE Acute Dxs in ICD10 codes]]
For a list of these CCI procedures on this wiki, see
=== Notes from reviewing the list ===
{{TT | just Tina's working notes:
Scenarios:
* one of a * of ICD10s
* one of a * of ICD10s AND one of a * of ICD10s
* one of a * of ICD10s AND an ICD10 with a word in it
* one of a * of ICD10s AND one of a * of CCIs
* one of a * of CCIs
* two or more of a * of ICD10s
AND any admit procedure is EITHER:
(a) of the form 1.AA.xx, 1.AB.xx, 1.AC.xx, 1.AE.xx, 1.AD.xx, 1.AG.xx, 1.AJ.xx, 1.AK.xx, 1.AN.xx, 1.AP.xx
::    where “xx” {{=}} any of 13, 51, 52, 53, 56, 57, 59, 72, 76, 80, 87, 89, 90, 91
or
(b) 2.AA.71.yy, 2.AB.71.yy, 2.AC.71.yy, 2.AE.71.yy, 2.AD.71.yy, 2.AG.71.yy, 2.AJ.71.yy, 2.AK.71.yy, 2.AN.71.yy, 2.AP.71.yy
::    where “yy” {{=}} any of 70.^, 71.^
* one of a * of ICD10s AND (one of * of CCI1 and a * of CCI2)
** might be able to do a pattern recognition on that? Or a regular expression?
}}
{{TT |
* I will need to re-think how these are documented on the wiki as well, as the current schema was based on individual dxs meeting criteria and this is quite different. [[User:Ttenbergen|Ttenbergen]] 10:39, 2022 November 15 (CST)
}}
Allan updated the original list and documented some reasons for decisions at item 13 in [[Task Team Meeting - Rolling Agenda and Minutes 2022#‎ICU Database Task Group Meeting – July 13, 2022]].
== Reporting  of the Eight Major Diagnostic Categories ==
*Reported as counts and percentage by unit and time period
*Graphically as stackable vertical bar chart
*Time period - quarterly
==Report Users==
*Critical Care Directors and Site  Managers
*Critical Care Quality Improvement Team (QIT)
==SAS Program==
*S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\1-prepCC_QI_startJan2022.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ICD10_ApachePredHospMort_byPriority.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\3-prepCCChart_ApacheDxGrp_94_startJan2020.sas


== Related Articles ==
== Related Articles ==

Latest revision as of 11:39, 15 November 2022

This is about the disease category which is one of the components in the model of predicting hospital mortality. The other components of the model are the APACHE Score and the presence or absence of Emergency Surgery (concept).

This is not about Chronic Health APACHE or the APACHE Comorbid Diagnoses.

Indicators
Indicator: ICU Diagnostic Categories by APACHE II
Created/Raw: Created
Program: Critical Care
Start Date: Oct 2016
End Date:
Reports: No reports on this wiki list this as an indicator.


  • Cargo


  • SMW:
  • Categories
  • Default form:

How to Determine the Diagnosis Category For each Patient

  • Each disease category or diagnosis leading to ICU admission has an associated weight in the model and varies for non-operative and post-operative patients.
    • Post-operative patients are those with Previous Location either Operating Room or Recovery Room.
  • There are weights for specific diagnosis categories and for major organ systems. The specific diagnosis category leading to ICU admission will first be determined based on the priority list in the descending order of the weights and if found none, then the major organ system following the priority list also in descending order will be used instead.
    • For non-operative patients, there are 24 specific diagnosis categories while 18 for post-operative patients; total of 42 which are shown in the S_ICD10_APACHE_Dx_patterns table.
    • There are 5 major vital organ system for both non-operative and post-operative patients (e.g. Nuerological, Cardiovascular, Respiratory, Gastrointestinal, Metabolic/renal) and all others NOS.
  • The diagnosis having the highest weight is assigned to the patient.
  • The 42 diagnosis categories are further grouped into eight major diagnostic categories for reporting purposes namely:
    • Respiratory Disorders, Cardiac Disease, Post Cardiac Arrest, Neurologic Disorders,
    • Trauma and Poisoning, Post-Operative Care, Metabolic/Renal/GI/Hypovolemic Shock, Sepsis and Septic Shock

ICD10 Mapping of Diagnosis Category

  • Before Jan 2019, Drs. Carla Chrusch and Kendiss Olafson did the mapping of the old admit diagnosis coding to the diagnosis categories included in the model.
  • Starting Jan 2019, Dr. Allan Garland did the mapping of the admit ICD10 codes and CCI codes to the diagnosis categories included in the model.

Implementation in CCMDB

The

draws on the

The contents of the

are then used by the

to provide the list of ICD10 APACHE Acute Diagnoses for patient records.

For a list of these diagnoses on this wiki, see

For a list of these CCI procedures on this wiki, see

Notes from reviewing the list

just Tina's working notes: Scenarios:

  • one of a * of ICD10s
  • one of a * of ICD10s AND one of a * of ICD10s
  • one of a * of ICD10s AND an ICD10 with a word in it
  • one of a * of ICD10s AND one of a * of CCIs
  • one of a * of CCIs
  • two or more of a * of ICD10s

AND any admit procedure is EITHER: (a) of the form 1.AA.xx, 1.AB.xx, 1.AC.xx, 1.AE.xx, 1.AD.xx, 1.AG.xx, 1.AJ.xx, 1.AK.xx, 1.AN.xx, 1.AP.xx

where “xx” = any of 13, 51, 52, 53, 56, 57, 59, 72, 76, 80, 87, 89, 90, 91

or (b) 2.AA.71.yy, 2.AB.71.yy, 2.AC.71.yy, 2.AE.71.yy, 2.AD.71.yy, 2.AG.71.yy, 2.AJ.71.yy, 2.AK.71.yy, 2.AN.71.yy, 2.AP.71.yy

where “yy” = any of 70.^, 71.^
  • one of a * of ICD10s AND (one of * of CCI1 and a * of CCI2)
    • might be able to do a pattern recognition on that? Or a regular expression?
  • added: no added date
  • action: no action date
  • Cargo


  • Categories
  • I will need to re-think how these are documented on the wiki as well, as the current schema was based on individual dxs meeting criteria and this is quite different. Ttenbergen 10:39, 2022 November 15 (CST)
  • added: no added date
  • action: no action date
  • Cargo


  • Categories

Allan updated the original list and documented some reasons for decisions at item 13 in Task Team Meeting - Rolling Agenda and Minutes 2022#‎ICU Database Task Group Meeting – July 13, 2022.


Reporting of the Eight Major Diagnostic Categories

  • Reported as counts and percentage by unit and time period
  • Graphically as stackable vertical bar chart
  • Time period - quarterly

Report Users

  • Critical Care Directors and Site Managers
  • Critical Care Quality Improvement Team (QIT)

SAS Program

  • S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\1-prepCC_QI_startJan2022.sas
  • S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ICD10_ApachePredHospMort_byPriority.sas
  • S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\3-prepCCChart_ApacheDxGrp_94_startJan2020.sas

Related Articles

Related articles:
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