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APACHE Scoring table: Difference between revisions

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== Physiological Variables ==
== Physiological Variables ==
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
}}


''see [[Field Ranges and Decimal Settings]] for maximum and extreme ranges''
== definitions ==
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]]


{| border="1" class="wikitable"
=== number of decimal points in definitions ===
|- align="center" style="background-color:#CCCCE6;font-weight:bold"
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.
| variable
This is solved by rounding the value to one decimal point and applying the score to that.
| Abs Min
| Warn Min
| 4
| 3
| 2
| 1
| 0
| 1
| 2
| 3
| 4
| Warn Max
| Abs Max
|- align="center"


| style="background-color:#CCCCE6" | [[Temperature]] (C)
=== [[Glasgow Coma Scale]] (GCS) ===
| 24
| 25.8
| ≥41
| 39-40.9
|  
| 38.5-38.9
| style="background-color:#CCCCE6" | 36-38.4
| 34-35.9
| 32-33.9
| 30-31.9
| ≤ 29.9
| 42.7
| 42.7
|- align="center"
 
 
| style="background-color:#CCCCE6" | [[Mean BP]] (mm Hg)
| SBP 19,
 
DBP 5
| SBP 25,
 
DBP 5
| ≥160
| 130-159
| 110-129
|
| height="16" style="background-color:#CCCCE6" | 70-109
|  
| 50-69
|  
| ≤49
| SBP 308,
 
DBP 188
| SBP 344,
 
DBP 200
|- align="center"
 
 
| height="16" style="background-color:#CCCCE6" | [[HR]] (beats per minute)
| 5
| 10
| ≥180
| 140-179
| 110-139
|  
| style="background-color:#CCCCE6" | 70-109
|  
| 55-69
| 40-54
| ≤39
| 250
| 250
|- align="center" valign="top"
 
| style="background-color:#CCCCE6" | [[RR]] (breaths per minute)
| 2
| 2
 
| ≥50
| 35-49
|  
| 25-34
| style="background-color:#CCCCE6" | 12-24
| 10-11
| 6-9
|
| ≤5
| 79
| 95
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" |  [[AaDO2]] (if [[FiO2|FiO<sub>2</sub>]] &gt;= 50% - *2)
| *1
| *1
| ≥500
| 350-499
| 201-349
| &nbsp;
| style="background-color:#CCCCE6" | &lt;=200
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
| *1
| *1
|- align="center" valign="top"
 
 
| height="16" style="background-color:#CCCCE6" |  [[PO2]] (mm Hg) (if [[FiO2|FiO<sub>2</sub>]] &lt; 50% - *2)
| 7
| 7
 
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
| style="background-color:#CCCCE6" | 70
| 61-69
| &nbsp;
| 55-60
| ≤54
| 600
| 600
|- align="center" valign="top"
 
 
| height="16" style="background-color:#CCCCE6" | [[Serum CO2]] (If no ABG)  - *2
| 2
| 2
| ≥52
| 41-51.9
| &nbsp;
| 32-40.9
| style="background-color:#CCCCE6" | 22-31.9
| &nbsp;
| 18-21.9
| 15-17.9
| ≤14
| 59
| 59
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" | [[PH|Arterial pH]]  - *2
| 6
| 6
| ≥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
| 7.97
| 7.99
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" | [[Na]] (mmol/L)
| 70
| 100
| ≥180
| 160-179
| 155-159
| 150-154
| style="background-color:#CCCCE6" | 130-149
| &nbsp;
| 120-129
| 111-119
| ≤110
| 190
| 200
 
|- align="center" valign="top"
| height="16" style="background-color:#CCCCE6" | [[K]] (mmol/L)
| 1
| 1
| ≥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
| 9.9
| 12
 
|- align="center" valign="top"
| height="26" style="background-color:#CCCCE6" | [[Creatinine]] (mmol/L)
(*Double point if yes for [[ARF (APACHE)|ARF]])
| 2
| 5
| ≥309
| 178-308
| 133-177
| &nbsp;
| style="background-color:#CCCCE6" | 53-132
| &nbsp;
| ≤52
| &nbsp;
| &nbsp;
| 2288
| 2785
 
|- align="center" valign="top"
| height="16" style="background-color:#CCCCE6" | [[HCT]] (unit?)
| 3
| 3
| ≥60
| &nbsp;
| 50-59.9
| 46-49.9
| style="background-color:#CCCCE6" | 30-45.9
| &nbsp;
| 20-29.9
| &nbsp;
| ≤19
| 68
| 78
 
|- align="center" valign="top"
| height="16" style="background-color:#CCCCE6" | [[WBC]](?unit)
| 0.01
| 0.02
| ≥40
| &nbsp;
| 20-39.9
| 15-19.9
| style="background-color:#CCCCE6" | 3-14.9
| &nbsp;
| 1-2.9
| &nbsp;
| &lt;1
| 301
| 517
|}
 
=== *1 AaDO2 component max/min values ===
* FIO2 ranges acceptable from 21-100
* CO2 warning range 2-285, absolute range 2-440
 
=== Arterial Blood Gas (ABG) scoring ===
* If '''no''' ABG
** apply score only for the SerCO2
** '''ignore pH component'''
* else (ie. ABG present)
** apply pH score
** if FIO2 >= 50
*** apply AaDO2 score
** else (ie FIO2 < 50)
*** apply PO2 score
 
== [[Glasgow Coma Scale]] (GCS) ==
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
*GCS = EYE point + MOTOR point + VERBAL point
*GCS = EYE point + MOTOR point + VERBAL point
*Neurological Points = 15 - GCS
*Neurological Points = 15 - GCS
=== Acute Physiologic Score (APS) ===
APS = [[#Physiological_Variables]] points + Neurological points from GCS
==== Inclusion of pH in absence of other ABG components ====
include it


== [[Age]] Points ==
== [[Age]] Points ==
Line 291: Line 72:


== Chronic Health Score ==
== Chronic Health Score ==
'''Apparently this is defined here and implemented incorrectly as compared with actual APACHE; see [[Chronic_Health_APACHE#Potential change]].''' Ttenbergen
The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]] as follows:


The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]]as follows:
=== 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:
: If admit type "Medical" or "Emergency Surgery" then
:: Score = 5
:: Score = 5
: else
: If "elective surgery" PLUS one or more [[Chronic Health APACHE]]is present:
:: if Chronic Disease is "none" then  
::Score = 2
::: Score = 0
:if [[Chronic Health APACHE]] is "none" then  
:: else (i.e. if Chronic)
:: Score = 0
::: Score = 2


==Total Apache Score==
==Total Apache Score==
TotApache = APS + Neurological points from GCS + Chronic Health points+ agepts
TotApache = APS + Chronic Health points+ agepts
 
TotApache MAX =74
 
== Related articles ==
{{Related Articles}}


===APSpts - Acute Physiological Points===
APS = scores as per [[#Physiological_Variables]]




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