APACHE Acute Diagnoses

This is about the disease category which is one of the components in the model of predicting hospital mortality. The other components of the model are the APACHE Score and the presence or absence of Emergency Surgery (concept).

This is not about Chronic Health APACHE or the APACHE Comorbid Diagnoses.

How to Determine the Diagnosis Category For each Patient

• Each disease category or diagnosis leading to ICU admission has an associated weight in the model and varies for non-operative and post-operative patients.
  • Post-operative patients are those with Previous Location either Operating Room or Recovery Room.
• There are weights for specific diagnosis categories and for major organ systems. The specific diagnosis category leading to ICU admission will first be determined based on the priority list in the descending order of the weights and if found none, then the major organ system following the priority list also in descending order will be used instead.
  • For non-operative patients, there are 24 specific diagnosis categories while 18 for post-operative patients; total of 42 which are shown in the S_ICD10_APACHE_Dx_patterns table.
  • There are 5 major vital organ system for both non-operative and post-operative patients (e.g. Nuerological, Cardiovascular, Respiratory, Gastrointestinal, Metabolic/renal) and all others NOS.
• The diagnosis having the highest weight is assigned to the patient.
• The 42 diagnosis categories are further grouped into eight major diagnostic categories for reporting purposes namely:
  • Respiratory Disorders, Cardiac Disease, Post Cardiac Arrest, Neurologic Disorders,
  • Trauma and Poisoning, Post-Operative Care, Metabolic/Renal/GI/Hypovolemic Shock, Sepsis and Septic Shock
    • The 8 major categories are included in S_ICD10_APACHE_Dx_patterns table.

ICD10 Mapping of Diagnosis Category

• Before Jan 2019, Drs. Carla Chrusch and Kendiss Olafson did the mapping of the old admit diagnosis coding to the diagnosis categories included in the model.
• Starting Jan 2019, Dr. Allan Garland did the mapping of the admit ICD10 codes and CCI codes to the diagnosis categories included in the model.
  • The list of admit diagnosis ICD10 codes is shown in APACHE Acute Dxs in ICD10 codes

The list of admit CCI procedures used in combination with the admit ICD10 codes is shown in Need to document this. Ttenbergen 16:09, 2022 June 2 (CDT)

added: no added date action: no action date

• Cargo

• Categories

Implementation in CCMDB

The

• S_ICD10_APACHE_Dx query

draws on the

• S_ICD10_APACHE_Dx_patterns table and the s_ICD10 table

The contents of the

• S_ICD10_APACHE_Dx query

are then used by the

• L_ICD10_APACHE_Dx query

to provide the list of ICD10 APACHE Acute Diagnoses for patient records.

For a list of these diagnoses on this wiki, see

• APACHE Acute Dxs in ICD10 codes

For a list of these CCI procedures on this wiki, see

same as above

added: no added date action: no action date

• Cargo

• Categories

Reporting of the Eight Major Diagnostic Categories

• Reported as counts and percentage by unit and time period
• Graphically as stackable vertical bar chart
• Time period - quarterly

SAS Program

• S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\1-prepCC_QI_startJan2022.sas
• S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ICD10_ApachePredHospMort_byPriority.sas
• 3-prepCCChart_ApacheDxGrp_94_startJan2020.sas