APACHE physiological variable collection

When to collect, which value to use

See Selection and timing of APACHE components

Exceptionally high or low values

CCMDB.accdb has error checks for values that are unlikely high or low to prevent errors. The ranges were determined by the statistician based on previous data(see abs min and abs max in APACHE_Scoring_table). To keep the checks meaningful the threshold values will not be changed for extreme outliers.

For values outside the "warning" limit, you must enter the reason for this into the Notes field so that we can validate that these were not errors.

For values outside the "absolut" limit, enter the closest value allowed and enter a comment into the Notes field. Also, email Pagasa the correct value.

Guidelines for the Values to use for APACHE II Physiologic Variables

• You can not enter 0 for any of these, and you can't leave them blank.
• The general rule is to use the WORST value in the initial 24 hours of the ICU record (remember that ICU records begin when the patient begins being cared for by the ICU service, not when he/she arrives in the ICU)
  • What we mean by "worst" is as per APACHE II rules
• If for a given parameter there are NO values during that initial 24 hours after the start of the ICU record, you can go back prior to the start of the ICU record, and use the value closest to the start time of the ICU record (but max 24 hrs prior to admission).
  • If there are no values for that parameter either during the first 24 hours OR up to 24 hours prior to the start of the ICU record, APACHE assumes the value was normal -- so code the value that is the midpoint of the normal range per APACHE rules.
• In regards to values that occurred or measured during cardiopulmonary arrests:
  • DO NOT use vital signs from arrests
  • You can use labs drawn during arrests, but only do so if these are the ONLY labs available.
• For the lab data, you can use values both from the central laboratory and those done on a bloodgas machine.