APACHE Scoring table: Difference between revisions

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The calculation of the store happens automatically and data collectors do not need to fit patient scores into this ranking or perform calculations.  
The calculation of the store happens automatically and data collectors do not need to fit patient scores into this ranking or perform calculations.  


== Physiological Variables==
== Physiological Variables ==
''see [[Field Ranges and Decimal Settings]] for maximum and extreme ranges''
MAX score = 48
{{#ask: [[Category:APACHE II Physiological Variables]]  
| ?AP phys name
| ?AP phys unit
| ?AP phys absMax
| ?AP phys warnMax
| ?AP H4
| ?AP H3
| ?AP H2
| ?AP H1
| ?AP 0
| ?AP L1
| ?AP L2
| ?AP L3
| ?AP L4
| ?AP phys warnMin
| ?AP phys absMin
|sort=AP phys name
|order=ascending
|format=broadtable
|default=Problem with SMW ask call
|headers=show
|class=sortable wikitable smwtable
}}


{| class="wikitable" border=1 <hiddentext> set to 0 for no borders</hiddentext>
== definitions ==
|- style="background-color:#CCCCE6;font-weight:bold" align="center" valign="top"
A lot of these values follow very specific definitions and collection instructions. See individual linked articles for details. Especially, see
| width="125" height="16" | Points
* [[Mean BP]]
| width="48" | 4
* [[Arterial blood gas (APACHE)]]
| width="48" | 3
* [[Glasgow Coma Scale]]
| width="48" | 2
| width="48" | 1
| width="48" | 0
| width="48" | 1
| width="48" | 2
| width="48" | 3
| width="48" | 4


|-  align="center" valign="top"
=== number of decimal points in definitions ===
|style="background-color:#CCCCE6" height="16" | 1. [[temperature]]
Some values arrive with a higher decimal precision than the definitions. Since the definitions have holes, that would lead to values in the holes being undefined for points.
This is solved by rounding the value to one decimal point and applying the score to that.


(C)
=== [[Glasgow Coma Scale]] (GCS) ===
|| ≥41
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
|| 39-40.9
*GCS = EYE point + MOTOR point + VERBAL point
|| &nbsp;
*Neurological Points = 15 - GCS
|| 38.5-38.9
=== Acute Physiologic Score (APS) ===
|style="background-color:#CCCCE6" height="16" | 36-38.4
APS = [[#Physiological_Variables]] points + Neurological points from GCS
|| 34-35.9
|| 32-33.9
|| 30-31.9
| ≤ 29.9
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 2. [[mean BP]]
(mm Hg)
| ≥160
| 130-159
| 110-129
|
|style="background-color:#CCCCE6" height="16" | 70-109
| &nbsp;
| 50-69
| &nbsp;
| ≤49
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 3. [[HR]]
(beats per minute)
| ≥180
| 140-179
| 110-139
| &nbsp;
|style="background-color:#CCCCE6" | 70-109
| &nbsp;
| 55-69
| 40-54
| ≤39
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 4. [[RR]]
(breaths
per
minute)
| ≥50
| 35-49
| &nbsp;
| 25-34
|style="background-color:#CCCCE6" | 12-24
| 10-11
| 6-9
|
| ≤5
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 5a. [[FiO2#Relevance|AaDO2]] (if [[FiO2|FiO<sub>2</sub>]] >= 50%)
| ≥500
| 350-499
| 201-349
| &nbsp;
|style="background-color:#CCCCE6" | <=200
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 5b. [[PO2]]
(mm Hg)
(if [[FiO2|FiO<sub>2</sub>]] < 50%)
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
|style="background-color:#CCCCE6" | 70
| 61-69
| &nbsp;
| 55-60
| ≤54
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 5c. [[Serum CO2]] (If no ABG)
| ≥52
| 41-51.9
| &nbsp;
| 32-40.9
|style="background-color:#CCCCE6" | 22-31.9
| &nbsp;
| 18-21.9
| 15-17.9
| ≤14
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 6. [[pH|Arterial pH]]
| ≥7.7
| 7.6-7.69
| &nbsp;
| 7.5-7.59
|style="background-color:#CCCCE6" | 7.33-7.49
| &nbsp;
| 7.25-7.32
| 7.15-7.24
| ≤ 7.14
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 7. [[Na]]
(mmol/L)
| ≥180
| 160-179
| 155-159
| 150-154
|style="background-color:#CCCCE6" | 130-149
| &nbsp;
| 120-129
| 111-119
| ≤110
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 8. [[K]] (mmol/L)
| ≥7
| 6-6.9
| &nbsp;
| 5.5-5.9
|style="background-color:#CCCCE6" | 3.5-5.4
| 3-3.4
| 2.5-2.9
| &nbsp;
| ≤2.4


|-  align="center" valign="top"
==== Inclusion of pH in absence of other ABG components ====
|style="background-color:#CCCCE6" height="26" | 9. [[Creatinine]] (mmol/L) (*Double point if yes for  [[ARF (APACHE)|ARF]])
include it
| ≥309
| 178-308
| 133-177
| &nbsp;
|style="background-color:#CCCCE6" | 53-132
| &nbsp;
| ≤52
| &nbsp;
| &nbsp;
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 10. [[HCT]] (unit?)
| ≥60
| &nbsp;
| 50-59.9
| 46-49.9
|style="background-color:#CCCCE6" | 30-45.9
| &nbsp;
| 20-29.9
| &nbsp;
| ≤19
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="16" | 11. [[WBC]](?unit)
| ≥40
| &nbsp;
| 20-39.9
| 15-19.9
|style="background-color:#CCCCE6" | 3-14.9
| &nbsp;
| 1-2.9
| &nbsp;
| <1
|}
 
== [[Glasgow Coma Scale]] ==
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
*GCS


== [[Age]] Points ==
== [[Age]] Points ==
Line 213: Line 72:


== Chronic Health Score ==
== Chronic Health Score ==
The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]].
The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]] as follows:


The chronic health score is generated as follows:
=== Correct scoring for Apache II Chronic Health ===
{| class="wikitable" border=1
: If admit type is: "Medical (non operative)" or "Emergency Surgery" PLUS one or more [[Chronic Health APACHE]] is present:
|-
:: Score = 5
|style="background-color:#CCCCE6"| Points|| Chronic Health Status
: If "elective surgery" PLUS one or more [[Chronic Health APACHE]]is present:
|-
::Score = 2
|style="background-color:#CCCCE6"| 0|| No history of chronic disease
:if [[Chronic Health APACHE]] is "none" then
:: Score = 0


|-
==Total Apache Score==
|style="background-color:#CCCCE6"| 2|| Elective Post op with history of chronic disease
TotApache = APS + Chronic Health points+ agepts


|-
TotApache MAX =74
|style="background-color:#CCCCE6"| 5|| Non OP (medical) or emergency post op with history of chronic disease


|}
== Related articles ==
{{Related Articles}}




{{discussion}}
What about those with chronic health and no surgery at all? [[User:Ttenbergen|Ttenbergen]] 16:37, 28 October 2010 (CDT)
* no surgery +  CH= 5 points (non OP medical). --[[User:TOstryzniuk|TOstryzniuk]] 13:42, 29 October 2010 (CDT)
** so someone with a history of chronic disease would be considered at '''lower''' risk if they have surgery than if they don't? [[User:Ttenbergen|Ttenbergen]] 10:07, 1 November 2010 (CDT)
==Total Apache Score==
TotApache = APS + GCS + Chronic Health points+ agepts
==APSpts-Acute Physiological Points==
APS= scores Apache items 1 to 11 + GCS


[[Category:APACHE II]]
[[Category:APACHE II | *]]
[[Category:APACHE II Physiological Variables]]
[[Category:APACHE II Physiological Variables | *]]
[[Category:ABG]]