APACHE Scoring table

The Scoring table for APACHE II describes how various fields we collect affect the ultimate APACHE II score.

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

MAX score = 48

	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
AaDO2	Alveolar-arterial oxygen tension difference				>500	>=350 and <500	>=200 and <350		<200
AP Dias BP Field	Diastolic blood pressure	mmHG	200	128					as per Mean BP					25	15
HR	Heart Rate	beats/min	205	250	>=180	>=140 and <180	>=110 and <140		>=70 and <110		>=55 and <70	>=40 and <55	<40	10	5
K	Potassium	mmol/L	12	9.9	=>7	>=6 and <7		>=5.5 and <6	>=3.5 and <5.5	>=3 and <3.5	>=2.5 and <3		<2.5	1	1
Serum CO2	Serum CO2	mmol/L	440	285	≥52	>=41 and <52		>=32 and <41	>= 22 and <32		>=18 and <22	>=15 and <18	<15	2	2
Na	Sodium	mmol/L	200	190	>=180	>=160 and <180	>=155 and <160	>=150 and <155	>=130 and <150		>=120 and <130	>=111 and <120	≤111	100	70
AP Sys BP Field	Systolic Blood Pressure	mmHG	360	243					as per Mean BP					49	25
Temperature	Temperature	°C	42.7	42.7	>=41	>=39 and <41		>=38.5 and <39	>=36 and <38.5	>=34 and <36	>=32 and <34	>=30 and <32	<30	1	1
WBC	White Blood Count	x109/L	517	301	>=40		>=20 and <40	>=15 and <20	>=3 and <15		>=1 and <3		<1	0.02	0.01
FiO2	fraction of inspired oxygen	percentage	100	100					as per AaDO2					20	20
HCT	hematocrit	percentage	3	3	>=60		>=50 and <60	>=46 and <50	>=30 and <46		>=20 and <30		<20	68	78
Mean BP	mean blood pressure	mmHG			>=160	>=130 and <160	>=110 and <130		>=70 and <110		>=50 and <70		<49
PCO2	partial pressure of carbon dioxide in arterial blood	mmol/L	440	285					AaDO2					2	2
PO2	partial pressure of oxygen	mmHG	650	650					>=70	>=60 and <70		>=55 and <60	<55	4	3
PH	ph		7.99	7.97	>=7.7	>=7.6 and <7.7		>=7.5 and <7.6	>=7.33 and <7.5		>=7.25 and <7.33	>=7.15 and <7.25	<7.15	6	6
RR	respiratory rate	breaths/min	95	79	>=50	>=35 and <50		>=25 and <35	>=12 and <25	>=10 and <12	>=6 and <10		<6	2	2
Creatinine (APACHE)	serum creatinine	µmol/L			>=309	>=178 and <309	>=133 and <178		>=53 and <133		≤52			5	2

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

number of decimal points in definitions

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. This is solved by rounding the value to one decimal point and applying the score to that.

Glasgow Coma Scale (GCS)

For information on collecting and coding the values, see the Glasgow Coma Scale article.

• GCS = EYE point + MOTOR point + VERBAL point
• 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

JALT Generally, if a pH value is present, other ABG values will be present as well. However, what if only a pH value is present? Should it's score be summed into the physiological score or not? The original paper: https://sci-hub.se/10.1097/00003246-198510000-00009 . We only have 2 records in our DB that have pH without other ABG values, and for one the pH score is 0, so Julie and Tina didn't notice this difference until now. Interpretations are: reasoning to include in sum, Julie's interpretation: "under DEVELOPMENT OF APACHE “ …and serum pH was retained in preference to bicarbonate”" reasoning to exclude it, Tina's interpretation: Paper said “Serum HCO2 … [Not preferred, use if no ABGs]”. So, some ABGs missing, use SerCO2 instead.

• SMW

• Cargo

• Categories

Age Points

The age of the patient is automatically generated from the date of birth and the date of admission when collecting data.

Age	≤44	45-54	55-64	65-74	≥75
Points (agepts)	0	2	3	5	6

Chronic Health Score

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:

Score = 5

If "elective surgery" PLUS one or more Chronic Health APACHEis present:

Score = 2

if Chronic Health APACHE is "none" then

Score = 0

Total Apache Score

TotApache = APS + Chronic Health points+ agepts

TotApache MAX =74