Chronic Health APACHE: Difference between revisions

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''This article is about Chronic Health in the context of the APACHE score, see [[Comorbid Diagnosis]] for info on the comorbidities we collect, and [[Charlson Comorbidity Index]] for the Charlson comorbidities that are also used for the [[Alert]] score.''

''This article is about Chronic Health in the context of the APACHE score, see '''[[Comorbid Diagnosis]]''' for info on the comorbidities we collect, and '''[[Charlson Comorbidity Index]]''' for the Charlson comorbidities that are also used for the '''[[Alert]]''' score.''

This value is now derived from ICD10 diagnoses, see [[Change for Apache Chronic to ICD10 from separate variable]] for details.

{{Data_element

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| CCMDB_tab = Apache

| element_description = Specific chronic pre-existing conditions used for [[APACHE]] score.

| in_table = L_Log

| in_table = L_Log table

| data_type = string

| datafield_length = 30

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| created_raw = Raw

| data_element_sort_index = 56

| data_element_start_date =

| data_element_end_date = 2022-02-17

}}

This value is used in conjunction with [[Admit Type for APACHE II]] to calculate the [[APACHE_Scoring_table#Chronic_Health_Score|Chronic_Health_Score]], one of the components of the [[Category:APACHE II | APACHE II score]].

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{| class="wikitable" border=1

|- style="background-color:#CCFFCC"

|style="font-weight:bold" | Dropdown in CCMDB.~~mdb~~

|style="font-weight:bold" | Dropdown in CCMDB.accdb

|| Orignial APACHE II CH list with definitions

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* sufficiently advanced disease to suppress resistance to infection

* Include patients on methotrexate or cyclophosphamide, etc. (for autoimmune disorders)

* pt is on immunosuppressive drugs (RA or SLE pts)

* {{List of immunosuppressive drugs}}

|-

|| 2. '''Met Cancer'''

* sufficiently advanced disease to suppress resistance to infection *(should we have this category? Met Cancer is part of the immunocompromized section, as is lymphoma and AIDS. The guidelines for apache II on line do not have separate categories for met cancer,lymphoma or AIDS. (they are lumped into the immunocompromised section).

* sufficiently advanced disease to suppress resistance to infection

||

|-

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== Implementation ==

* Chronic Health is stored as a single-choice dropdown in [[CCMDB.~~mdb~~]]

* Chronic Health is stored as a single-choice dropdown in [[CCMDB.accdb]] and [[Centralized_data.accdb]]

* when sent for import into [[TMSX]] the chronic health score is translated into ''yes'' or ''no''

* There is an additional option "0HasChronic"; this can not be selected in [[CCMDB.accdb]] but is used in [[Centralized_data.accdb]] for old records that were imported from [[TMSX and MedTMS]] where the detailed data was not collected

== ICD10 ==

We are moving to derive this concept from [[APACHE Comorbidities in ICD10 codes]].

=== Change log ===

* 2022-02-17 - decided to stop collecting this and apply [[Change for Apache Chronic to ICD10 from separate variable]]

* 2022-02-09 - Julie, Tina and Allan discussed Julie's most recent analysis of this; there are still many differences in dx vs chronic, with higher and lower counts for different components. Allan quotes a paper that acknowledges this difference in count, but that the Apache ''score'' ends up similar. Question raised: is the saving of time in no longer collecting this as a field worth the loss of accuracy.

* 2021-04-22 - preliminary analysis of how deriving this from ICD10 would compare with previous manual collection; many differences; Tina emailed Allan and Julie, more to come

* 2021-04-19 - Added ''Drug-induced immunosuppression'' since that component of this code was not previously collected comprehensively

* 2021-03-11 - The list of drugs is at [[Template:List of immunosuppressive drugs]].

* 2021-02-22 - AG sent email to Julie and Tina to get back to this change.

* 2018-11-28 - AG confirmed that this is an option

== Legacy ==

* when sent for import into [[TMSX and MedTMS]] the chronic health score was translated into ''yes'' or ''no''; when we moved to [[Centralized_data.accdb]] these were imported as "0HasChronic"

* the fields were made into a pick list of 9 items that belong to one of the five APACHE II Chronic Health categories because Medicine wanted to use both [[APACHE II]] and [[SAPS II]] on Medicine patients. [[SAPS II]] and [[APACHE II]] scored these same chronic health items differently. SAPS is no longer collected.

== Related articles ==

[[Category:APACHE II]]

[[Category: APACHE II]]

@@ Line 1: / Line 1: @@
-  ''This article is about Chronic Health in the context of the APACHE score, see [[Comorbid Diagnosis]] for info on the comorbidities we collect, and [[Charlson Comorbidity Index]] for the Charlson comorbidities that are also used for the [[Alert]] score.''
+  ''This article is about Chronic Health in the context of the APACHE score, see '''[[Comorbid Diagnosis]]''' for info on the comorbidities we collect, and '''[[Charlson Comorbidity Index]]''' for the Charlson comorbidities that are also used for the '''[[Alert]]''' score.''
+This value is now derived from ICD10 diagnoses, see [[Change for Apache Chronic to ICD10 from separate variable]] for details.
 {{Data_element
@@ Line 6: / Line 8: @@
 | CCMDB_tab = Apache
 | element_description = Specific chronic pre-existing conditions used for [[APACHE]] score.
-| in_table = L_Log
+| in_table = L_Log table
 | data_type = string
 | datafield_length = 30
@@ Line 12: / Line 14: @@
 | created_raw = Raw
 | data_element_sort_index = 56
+| data_element_start_date =
+| data_element_end_date = 2022-02-17
 }}
 This value is used in conjunction with [[Admit Type for APACHE II]] to calculate the [[APACHE_Scoring_table#Chronic_Health_Score|Chronic_Health_Score]], one of the components of the [[Category:APACHE II | APACHE II score]].
@@ Line 22: / Line 25: @@
 {| class="wikitable" border=1
 |- style="background-color:#CCFFCC"
-|style="font-weight:bold" | Dropdown in CCMDB.mdb
+|style="font-weight:bold" | Dropdown in CCMDB.accdb
 || Orignial APACHE II CH list with definitions
@@ Line 36: / Line 39: @@
 * sufficiently advanced disease to suppress resistance to infection
 * Include patients on methotrexate or cyclophosphamide, etc. (for autoimmune disorders)
+* pt is on immunosuppressive drugs (RA or SLE pts)
+* {{List of immunosuppressive drugs}}
 |-
 || 2. '''Met Cancer'''
-* sufficiently advanced disease to suppress resistance to infection *(should we have this category? Met Cancer is part of the immunocompromized section, as is lymphoma and AIDS. The guidelines for apache II on line do not have separate categories for met cancer,lymphoma or AIDS. (they are lumped into the immunocompromised section).
+* sufficiently advanced disease to suppress resistance to infection
 ||
 |-
@@ Line 83: / Line 89: @@
 == Implementation ==
-* Chronic Health is stored as a single-choice dropdown in [[CCMDB.mdb]]
+* Chronic Health is stored as a single-choice dropdown in [[CCMDB.accdb]] and [[Centralized_data.accdb]]
-* when sent for import into [[TMSX]] the chronic health score is translated into ''yes'' or ''no''
+* There is an additional option "0HasChronic"; this can not be selected in [[CCMDB.accdb]] but is used in [[Centralized_data.accdb]] for old records that were imported from [[TMSX and MedTMS]] where the detailed data was not collected
+== ICD10  ==
+We are moving to derive this concept from [[APACHE Comorbidities in ICD10 codes]].
+=== Change log ===
+* 2022-02-17 - decided to stop collecting this and apply [[Change for Apache Chronic to ICD10 from separate variable]]
+* 2022-02-09 - Julie, Tina and Allan discussed Julie's most recent analysis of this; there are still many differences in dx vs chronic, with higher and lower counts for different components. Allan quotes a paper that acknowledges this difference in count, but that the Apache ''score'' ends up similar. Question raised: is the saving of time in no longer collecting this as a field worth the loss of accuracy.
+* 2021-04-22 - preliminary analysis of how deriving this from ICD10 would compare with previous manual collection; many differences; Tina emailed Allan and Julie, more to come
+* 2021-04-19 - Added ''Drug-induced immunosuppression'' since that component of this code was not previously collected comprehensively
+* 2021-03-11 - The list of drugs is at [[Template:List of immunosuppressive drugs]].
+* 2021-02-22 - AG sent email to Julie and Tina to get back to this change.
+* 2018-11-28 - AG confirmed that this is an option
+== Legacy ==
+* when sent for import into [[TMSX and MedTMS]] the chronic health score was translated into ''yes'' or ''no''; when we moved to [[Centralized_data.accdb]] these were imported as "0HasChronic"
 * the fields were made into a pick list of 9 items that belong to one of the five APACHE II Chronic Health categories because Medicine wanted to use both [[APACHE II]] and [[SAPS II]] on Medicine patients. [[SAPS II]] and [[APACHE II]] scored these same chronic health items differently. SAPS is no longer collected.
+== Related articles ==
+{{Related Articles}}
+[[Category:APACHE II]]
-[[Category: APACHE II]]