APACHE Scoring table: Difference between revisions
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| 7.99 | | 7.99 |
Revision as of 12:26, 23 April 2014
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
see Field Ranges and Decimal Settings for maximum and extreme ranges
variable | Abs Min | Warn Min | 4 | 3 | 2 | 1 | 0 | 1 | 2 | 3 | 4 | Warn Max | Abs Max |
Temperature (C) | 24 | 25.8 | ≥41 | 39-40.9 | 38.5-38.9 | 36-38.4 | 34-35.9 | 32-33.9 | 30-31.9 | ≤ 29.9 | 42.7 | 42.7 | |
Mean BP (mm Hg) | SBP 19,
DBP 5 |
SBP 25,
DBP 5 |
≥160 | 130-159 | 110-129 | 70-109 | 50-69 | ≤49 | SBP 308,
DBP 188 |
SBP 344,
DBP 200 | |||
HR (beats per minute) | 5 | 10 | ≥180 | 140-179 | 110-139 | 70-109 | 55-69 | 40-54 | ≤39 | 250 | 250 | ||
RR (breaths per minute) | 2 | 2 | ≥50 | 35-49 | 25-34 | 12-24 | 10-11 | 6-9 | ≤5 | 79 | 95 | ||
AaDO2 (if FiO2 >= 50% - *2) | *1 | *1 | ≥500 | 350-499 | 200-349 | <200 | *1 | *1 | |||||
PO2 (mm Hg) (if FiO2 < 50% - *2) | 7 | 7 | <70 | 61-70 | 55-60 | ≤54 | 600 | 600 | |||||
Serum CO2 (If no ABG) - *2 | 2 | 2 | ≥52 | 41-51.9 | 32-40.9 | 22-31.9 | 18-21.9 | 15-17.9 | <15 | 59 | 59 | ||
Arterial pH - *2 | 6 | 6 | ≥7.7 | 7.6-7.69 | 7.5-7.59 | 7.33-7.49 | 7.25-7.32 | 7.15-7.24 | < 7.15 | 7.97 | 7.99 | ||
Na (mmol/L) | 70 | 100 | ≥180 | 160-179 | 155-159 | 150-154 | 130-149 | 120-129 | 111-119 | ≤110 | 190 | 200 | |
K (mmol/L) | 1 | 1 | ≥7 | 6-6.9 | 5.5-5.9 | 3.5-5.4 | 3-3.4 | 2.5-2.9 | ≤2.4 | 9.9 | 12 | ||
Creatinine (mmol/L)
(*Double point if yes for ARF
|
2 | 5 | ≥309 | 178-308 | 133-177 | 53-132 | ≤52 | 2288 | 2785 | ||||
HCT (%) | 3 | 3 | ≥60 | 50-59.9 | 46-49.9 | 30-45.9 | 20-29.9 | ≤19.9 | 68 | 78 | |||
WBC(x10 9/L)) | 0.01 | 0.02 | ≥40 | 20-39.9 | 15-19.9 | 3-14.9 | 1-2.9 | ≤0.9 | 301 | 517 |
*1 AaDO2 component max/min values
- FIO2 ranges acceptable from 21-100
- CO2 warning range 2-285, absolute range 2-440
*2 - 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.
- GCS = EYE point + MOTOR point + VERBAL point
- Neurological Points = 15 - GCS
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
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:
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
-Trish Ostryzniuk 20:00, 2014 January 27 (CST)
Total Apache Score
TotApache = APS + Neurological points from GCS + Chronic Health points+ agepts
APSpts - Acute Physiological Points
APS = scores as per #Physiological_Variables