APACHE Scoring table: Difference between revisions
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== Physiological Variables == | == Physiological Variables == | ||
{{#ask: [[Category:APACHE II Physiological Variables]] | |||
| ?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 | |||
|sort=AP phys name | |||
|order=ascending | |||
|format=broadtable | |||
|default=Problem with SMW ask call | |||
|headers=show | |||
|class=sortable wikitable smwtable | |||
}} | |||
== 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 | |||
== [[Age]] Points == | |||
The age of the patient is automatically generated from the [[DOB field|date of birth]] and the date of admission when collecting data. | |||
{| class="wikitable" border=1 | |||
|- style="background-color:#CCCCE6;font-weight:bold" | |||
|| Age | |||
|| ≤44 | |||
|| 45-54 | |||
|| 55-64 | |||
|| 65-74 | |||
|| ≥75 | |||
|- | |||
|style="font-weight:bold" | 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 APACHE]]is 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 | |||
== Old table, keeping until we have confirmed new is same as old == | |||
{| border="1" class="wikitable" | {| border="1" class="wikitable" | ||
|- align="center" style="background-color:#CCCCE6;font-weight:bold" | |- align="center" style="background-color:#CCCCE6;font-weight:bold" | ||
Line 246: | Line 333: | ||
| 517 | | 517 | ||
|} | |} | ||
[[Category:APACHE II | *]] | [[Category:APACHE II | *]] | ||
[[Category:APACHE II Physiological Variables | *]] | [[Category:APACHE II Physiological Variables | *]] | ||
[[Category:ABG]] | [[Category:ABG]] |
Revision as of 14:35, 15 January 2017
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
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
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
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
Old table, keeping until we have confirmed new is same as old
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 |