APACHE Scoring table

The Scoring table for APACHE II describes how various fields we collect affect the ultimate APACHE II score. The score itself is automatically calculated, no manual addition needs to be performed.

Chemistry Values

Points	4	3	2	1	0	1	2	3	4
Temperature	≥41	39-40.9		38.5-38.9	36-38.4	34-35.9	32-33.9	30-31.9	≤
									29.9
m BP	≥160	130-159	110-129		70-109		50-69		≤49
HR	≥180	140-179	110-139		70-109		55-69	40-54	≤39
RR	≥50	35-49		25-34	Dec-24	10-Nov	6-Sep		≤5
AaDO2 (if FiO2 >= 50%)	≥500	350-499	201-349		200
PO2 (if FiO2 < 50%)					70	61-69		55-60	≤54
Arterial pH	≥7.7	7.6-7.69		7.5-7.59	7.33-7.49		7.25-7.32	7.15-7.24	≤ 7.14
Serum CO2 (If no ABG)	≥52	41-51.9		32-40.9	22-31.9		18-21.9	15-17.9	≤14
Na	≥180	160-179	155-159	150-154	130-149		120-129	111-119	≤110
K +	≥7	6-6.9		5.5-5.9	3.5-5.4	3-3.4	2.5-2.9		≤2.4
Creat (*Double point if yes for ARF)	≥309	178-308	133-177		53-132		52
HCT	≥60		50-59.9	46-49.9	30-45.9		20-29.9		≤19
WBC	≥40		20-39.9	15-19.9	3-14.9		1-2.9		<1

Glasgow Coma Scale

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

A Glasgow Coma Scale score of 15 would be considered "Total Neuro Points".

The Glasgow Coma Scale is scored in APACHE II as follows:

Points	6	5	4	3	2	1
EYES			Spontaneous	To Speech	To Pain	None
MOTOR	Obeys Command	Localizes Pain	Withdraws to Pain	Abnormal Flexion	Abnormal Extension	None
VERBAL		Oriented	Confused	Inappropriate words	Incomprehensive sounds	None

Calculations

Mean Blood Pressure

Mean BP = ((2x Diastolic) + Systolic) ÷ 3

AaDO2 (for Fi02 >= 50 %)

AaDO2 = ((FiO2 * 713) - P02) - C02

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	0	2	3	5	6

before de-stubbing

• confirm if age calculated from admission date

Chronic Health

We pull some of the values for the chronic health score from the coded diagnoses and some from ...

The Chronic health field is scored as follows:

Points	0	2	5
Chronic Health Status	No history of chronic disease	Elective Post op with history of chronic disease	Non OP (medical) or emergency post op with history of chronic disease

Chronic Disease can be one of the following:

Liver	any of biopsy proven cirrhosis & documented portal hypertension past episodes of GI bleeds, hepatic failure encephalopathy, coma
Cardiovascular	Class 4 Angina - pain @ rest or with minimal extertion
Respiratory	any of COPD Restrictive lung disease Vascular disease resulting in severe exercise restriction documented Hypoxia, hypercapnia, polycythemia Pulmonary HTN on home O2 Ventilator dependent
Renal	Receiving Chronic Dialysis
Immuno-compromised	Receiving therapy that suppresses resistance to infection such as Chemo Radiation ≥10 mg prednisone ≥15mg/kg/day hydrocortisone >3 mg/kg’day of methyoprednisolone for >5 days or sufficiently advanced disease to suppress resistance to infection Leukemia lymphoma Aids metastatic CA

to do before de-stubbing

• where do we pull the chronic data from?
• if we have chronic field (I seem to remember) we should list all its info separately and only give the scoring algorithm here.

FIO2 Table

see FiO2

to do before de-stubbing

• finish moving paper content to here.