ARF (APACHE): Difference between revisions

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''~~'''Note''':~~ Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code of Acute Renal Failure ~~see [[ARF (Diagnosis)]]~~

''Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code see any one of the several ICD10 codes for types/causes of ARF.

{{Data_element

| field_name = Ap_ARF

| CCMDB_label = ARF

| CCMDB_tab = Apache

| element_description = The ARF checkbox is checked/true if patient is in Acute Renal Failure as per the APACHE definition.

| in_table = L_Log table

| data_type = number

| datafield_length = single

| program_collecting = CC

| created_raw = Raw

| data_element_sort_index = 77

}}

== ~~Coding {{g | Guideline}}~~ ==

== Additional Info ==

~~For critical care only:~~

Use the following uniform definition for ARF/AKI everywhere, including for APACHE II.

~~The~~ ARF ~~('''A'''cute '''R'''enal '''F'''ailure) dropdown~~ for APACHE ~~defaults to "enter"; you won't be able to send unless you change it to one of the following:~~

~~'''Choose "yes"''' if the following conditions are met:~~

* patient is in ICU/Critical Care

* for ~~8 hrs consecutively in the first 24 hrs of admission:~~

** creatinine > 133 mmols and

** urine output < 135 cc

'''Choose "no"''' if the pt

== Coding Guideline ==

* has ~~CRF in comorbids~~

* For critical care only: The ARF ('''A'''cute '''R'''enal '''F'''ailure) dropdown for APACHE defaults to "enter"; you won't be able to send unless you change it to one of the following:

* ~~doesn~~'t ~~have CRF~~

* '''Choose "no"''' if the pt

** does not meet the [[#KDIGO Guidelines for Acute Kidney Injury (AKI)]] '''or'''

** has a diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] (with or without dialysis)

*** Special Case- If a patient comes to ICU with a past history of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] and had a kidney transplant during this admission. As per Allan, unless the transplanted kidney was truly working postop (i.e. didn't need dialysis for at least a week or two) then do not code ARF.

* otherwise choose "yes"'''

== Data Use ==

ARF is one component used to generate the [[:Category:APACHE II| APACHE II]] score.

Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[~~APACHE_Scoring_table~~#~~Physiological_Variables~~]])

Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[APACHE_II_Background#Weighting_of_scores]] and [[APACHE Scoring table#Physiological Variables]])

~~== Data Integrity Checks ==~~

* {{~~CCMDB~~ Data Integrity ~~Checks}}~~

** [[Check ~~ApARF CRF]]~~

* {{Cleaner.mdb Data Integrity Checks}}

** [[Renal Coding Considerations]]

==~~Related Articles~~ ==

== Historical==

~~see [[~~:~~Category~~:~~Renal Problem]] for other renal problems~~

*In original APACHE II there were no criteria given for what constitutes Acute Renal Failure. So, from 1988 until 2018 we used a set of simple criteria based only on the admission serum creatinine and absolute urine output. But, when on January 1, 2019 we moved to ICD10 and CCI coding, we decided to use a

*there were criteria for ARF in the APACHE II user manual 1986, from George Washington University, Ver 1.0, that we applied when we started in 1988, they were:

**creatinine PLUS oliguria. Oliguria was defined as: urine output of less than 135 cc over a consecutive 8 hr period in the first 24 hrs of ICU admission.

**Copy of this APACHE II User Manual can be found in the article archives library located in HSC JJ387.

== Related articles ==

[[Category:APACHE II Physiological Variables]]

[[Category:Renal Problem]]

[[Category:Renal Problem (old)]]

@@ Line 1: / Line 1: @@
-'''''Note''': Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code of Acute Renal Failure see [[ARF (Diagnosis)]]
+''Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code see any one of the several ICD10 codes for types/causes of ARF.
+{{Data_element
+| field_name = Ap_ARF
+| CCMDB_label = ARF
+| CCMDB_tab = Apache
+| element_description = The ARF checkbox is checked/true if patient is in Acute Renal Failure as per the APACHE definition.
+| in_table = L_Log table
+| data_type = number
+| datafield_length = single
+| program_collecting = CC
+| created_raw = Raw
+| data_element_sort_index = 77
+}}
-== Coding {{g | Guideline}} ==
+== Additional Info ==
-For critical care only:
+Use the following uniform definition for ARF/AKI everywhere, including for APACHE II.
-The ARF ('''A'''cute '''R'''enal '''F'''ailure) dropdown for APACHE defaults to "enter"; you won't be able to send unless you change it to one of the following:
-'''Choose "yes"''' if the following conditions are met:
+{{ICD10 Guideline KDIGO Guidelines for Acute Renal Failure}}
-* patient is in ICU/Critical Care
-* for 8 hrs consecutively in the first 24 hrs of admission:
-** creatinine > 133 mmols  and
-** urine output < 135 cc
-'''Choose "no"''' if the pt
+== Coding Guideline ==
-* has CRF in comorbids
+* For critical care only: The ARF ('''A'''cute '''R'''enal '''F'''ailure) dropdown for APACHE defaults to "enter"; you won't be able to send unless you change it to one of the following:
-* doesn't have CRF
+* '''Choose "no"''' if the pt
+** does not meet the [[#KDIGO Guidelines for Acute Kidney Injury (AKI)]] '''or'''
+** has a diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] (with or without dialysis)
+*** Special Case- If a patient comes to ICU with a past history of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] and had a kidney transplant during this admission.  As per Allan, unless the transplanted kidney was truly working postop (i.e. didn't need dialysis for at least a week or two) then do not code ARF.
+* otherwise choose "yes"'''
 == Data Use ==
 ARF is one component used to generate the [[:Category:APACHE II| APACHE II]] score.
-Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[APACHE_Scoring_table#Physiological_Variables]])
+Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[APACHE_II_Background#Weighting_of_scores]] and  [[APACHE Scoring table#Physiological Variables]])
-== Data Integrity Checks ==
+{{Data Integrity Check List}}
-* {{CCMDB Data Integrity Checks}}
-**  [[Check ApARF CRF]]
-* {{Cleaner.mdb Data Integrity Checks}}
-** [[Renal Coding Considerations]]
-==Related Articles ==
+== Historical==
-see [[:Category:Renal Problem]] for other renal problems
+*In original APACHE II there were no criteria given for what constitutes Acute Renal Failure.  So, from 1988 until 2018 we used a set of simple criteria based only on the admission serum creatinine and absolute urine output. But, when on January 1, 2019 we moved to ICD10 and CCI coding, we decided to use a
+*there were criteria for ARF in the APACHE II user manual 1986, from George Washington University, Ver 1.0, that we applied when we started in 1988, they were:
+**creatinine PLUS oliguria.  Oliguria was defined as: urine output of less than 135 cc over a consecutive 8 hr period in the first 24 hrs of ICU admission.
+**Copy of this APACHE II User Manual can be found in the article archives library located in HSC JJ387.
+== Related articles ==
+{{Related Articles}}
 [[Category:APACHE II Physiological Variables]]
-[[Category:Renal Problem]]
+[[Category:Renal Problem (old)]]