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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 ==
{| class="wikitable" border=1 <hiddentext> set to 0 for no borders</hiddentext>
MAX score = 48
|- style="background-color:#CCCCE6;font-weight:bold" align="center" valign="top"
{{#ask: [[Category:APACHE II Physiological Variables]]
| width="125" height="16" | Points
| ?AP phys name
| width="48" | 4
| ?AP phys unit
| width="48" | 3
| ?AP phys absMax
| width="48" | 2
| ?AP phys warnMax
| width="48" | 1
| ?AP H4
| width="48" | 0
| ?AP H3
| width="48" | 1
| ?AP H2
| width="48" | 2
| ?AP H1
| width="48" | 3
| ?AP 0
| width="48" | 4
| ?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
}}


|-  align="center" valign="top"
== definitions ==
|style="background-color:#CCCCE6" height="16" | [[temperature]]  
A lot of these values follow very specific definitions and collection instructions. See individual linked articles for details. Especially, see
* [[Mean BP]]
* [[Arterial blood gas (APACHE)]]
* [[Glasgow Coma Scale]]


(C)
=== number of decimal points in definitions ===
|| ≥41
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.  
|| 39-40.9
This is solved by rounding the value to one decimal point and applying the score to that.
|| &nbsp;
|| 38.5-38.9
|style="background-color:#CCCCE6" height="16" | 36-38.4
|| 34-35.9
|| 32-33.9
|| 30-31.9
| ≤ 29.9


|-  align="center" valign="top"
=== [[Glasgow Coma Scale]] (GCS) ===
|style="background-color:#CCCCE6" height="16" | [[mean BP]]
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
(mm Hg)
*GCS = EYE point + MOTOR point + VERBAL point
| ≥160
*Neurological Points = 15 - GCS
| 130-159
=== Acute Physiologic Score (APS) ===
| 110-129
APS = [[#Physiological_Variables]] points + Neurological points from GCS
|
|style="background-color:#CCCCE6" height="16" | 70-109
| &nbsp;
| 50-69
| ≤49


|-  align="center" valign="top"
==== Inclusion of pH in absence of other ABG components ====
|style="background-color:#CCCCE6" height="16" | [[HR]]
include it
(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"
== [[Age]] Points ==
|style="background-color:#CCCCE6" height="16" | [[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" | [[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" | [[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" | [[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" | [[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" | [[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" | [[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"
|style="background-color:#CCCCE6" height="26" | [[Creatinine]] (mmol/L) (*Double point if yes for  [[ARF - Acute Renal Failure|ARF]])
| ≥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" | [[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" | [[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.
 
A Glasgow Coma Scale score of 15 would be considered "Total Neuro Points".
 
The Glasgow Coma Scale is scored in APACHE II as follows:
 
{| class="wikitable" border=1 <hiddentext> set to 0 for no borders</hiddentext>
|- style="background-color:#CCCCE6;font-weight:bold" align="center" valign="top"
| width="125" height="16" align="right"| Points
| width="64" | 6
| width="58" | 5
| width="48" | 4
| width="48" | 3
| width="48" | 2
| width="48" | 1
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="27" | '''Eyes'''
| &nbsp;
| &nbsp;
| Spontaneous
| To Speech
| To Pain
| None
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="39" | '''Motor'''
| Obeys Command
| Localizes Pain
| Withdraws to Pain
| Abnormal Flexion
| Abnormal Extension
| None
 
|-  align="center" valign="top"
|style="background-color:#CCCCE6" height="38" | '''Verbal'''
| &nbsp;
| Oriented
| Confused
| Inappropriate words
| Incomprehensive sounds
| None
 
|}
 
 
 
== Age Points ==
The age of the patient is automatically generated from the [[DOB field|date of birth]] and the date of admission when collecting data.  
The age of the patient is automatically generated from the [[DOB field|date of birth]] and the date of admission when collecting data.  


{| class="wikitable" border=1  
{| class="wikitable" border=1  
|- style="background-color:#CCCCE6;font-weight:bold" valign="top" align="center"  
|- style="background-color:#CCCCE6;font-weight:bold"  
| width="58" height="16" | Age
|| Age
| width="48" | ≤44
|| ≤44
| width="48" | 45-54
|| 45-54
| width="48" | 55-64
|| 55-64
| width="48" | 65-74
|| 65-74
| width="48" | ≥75
|| ≥75


|- align="center" valign="top"
|-
|style="font-weight:bold" height="16" | Points
|style="font-weight:bold" | Points (agepts)
  | 0
  | 0
  | 2
  | 2
Line 253: Line 71:
|}
|}


== Chronic Health ==
== Chronic Health Score ==
We pull some of the values for the chronic health score from the coded diagnoses and some from ...
The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]] as follows:
*APACHE II has some "specific" underlying disease conditions that it uses.  Not just any code from the main DX code list.
 
**this information needs to be added here.
=== Correct scoring for Apache II Chronic Health ===
: If admit type is:  "Medical (non operative)" or "Emergency Surgery" PLUS one or more [[Chronic Health APACHE]] is present:
:: Score = 5
: If "elective surgery" PLUS one or more [[Chronic Health APACHE]]is present:
::Score = 2
:if [[Chronic Health APACHE]] is "none" then
:: Score = 0
 
==Total Apache Score==
TotApache = APS + Chronic Health points+ agepts
 
TotApache MAX =74


The [[Chronic health field]] is scored as follows:
== Related articles ==  
{| class="wikitable" border=1
{{Related Articles}}
|- style="background-color:#CCCCE6;font-weight:bold" valign="top"
| width="75" height="40" | Points
|style="font-weight:bold" width="75" | 0
|style="font-weight:bold" width="100" | 2
|style="font-weight:bold" width="150" | 5


|- valign="top"
|style="background-color:#CCCCE6" height="52" | Chronic Health  Status
| No history of chronic disease
| Elective Post op with history of chronic disease
| Non OP (medical) or emergency post op with history of chronic disease
|}
See [[Chronic Health Diagnosis for APACHE II]]




[[Category:APACHE II]]
[[Category:APACHE II | *]]
[[Category:APACHE II Physiological Variables | *]]
[[Category:ABG]]
Retrieved from "https://ccmdb.kuality.ca/index.php?title=APACHE_Scoring_table"