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

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 and <41

>=38.5 and <39

>=36 and <38.5

>=34 and <36

>=32 and <34

>=30 and <32

<30

42.7

42.7

Mean BP (mm Hg)

SBP 19, DBP 5

SBP 25, DBP 5

>=160

>=130 and <160

>=110 and <130

>=70 and <110

>=50 and <70

<49

SBP 308, DBP 188

SBP 344, DBP 200

HR (beats per minute)

5

10

>=180

>=140 and <180

>=110 and <140

>=70 and <110

>=55 and <70

>=40 and <55

<40

250

250

RR (breaths per minute)

2

2

≥50

>=35 and <50

>=25 and <35

>=12 and <25

>=10 and <12

>=6 and <10

<6

79

95

AaDO2 (if FiO2 >= 50% - *2)

*1

*1

>=500

>=350 and <500

>=200 and <350

<200 *4

*1

*1

PO2 (mm Hg) (if FiO2 < 50% - *2)

7

7

>=70

>=60 and <70

>=55 and <60

<55

600

600

Serum CO2 (If no ABG) - *2

2

2

≥52

>=41 and <52

>=32 and <41

>= 22 and <32

>=18 and <22

>=15 and <18

<15

59

59

Arterial pH - *2

6

6

>=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

7.97

7.99

Na (mmol/L)

70

100

>=180

>=160 and <180

>=155 and <160

>=150 and <155

>=130 and <150

>=120 and <130

>=111 and <120

≤111

190

200

K (mmol/L)

1

1

>=7

>=6 and <7

>=5.5 and <6

>=3.5 and <5.5

>=3 and <3.5

>=2.5 and <3

<2.5

9.9

12

Creatinine (mmol/L) (Double point if yes for ARF; see ARF for APACHE II)

2

5

>=309

>=178 and <309

>=133 and <178

>=53 and <133

≤52

2288

2785

HCT (%)

3

3

>=60

>=50 and <60

>=46 and <50

>=30 and <46

>=20 and <30

<20

68

78

WBC(x10 9/L)(*3)

0.01

0.02

>=40

>=20 and <40

>=15 and <20

>=3 and <15

>=1 and <3

<1

301

517

*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 worst AaDO2 score
  • else (ie FIO2 < 50)
    • apply worst PO2 score

Select the ABG (arterial blood gas) with the WORST AaDO2 or the WORST PO2, which ever one gives you the highest APACHE II points in the first 24 hrs of ICU admission.

*3 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.

*4 AaDO2 can be 0 or negative

Unlike other physiological variables AaDO2 can be 0 or negative, so onlike the others the score for a 0 AaDO2 is 0 if AaDO2 < 200, which includes AaDO2<=0.

Note for programming only: The score is still null if the AaDO2 is null.

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

APSpts - Acute Physiological Points

APS = scores as per #Physiological_Variables

APSpts MAX score = 48

Total Apache Score

TotApache = APS #Physiological_Variables points + Neurological points from GCS + Chronic Health points+ agepts

TotApache MAX =74

Testing SMW APACHE Score

Just testing for now to get the template right.

	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