APACHE Acute Diagnoses
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This is about the disease category which is one of the components in the model of predicting hospital mortality. The other components of the model are the APACHE Score and the presence or absence of Emergency Surgery (concept).
This is not about Chronic Health APACHE or the APACHE Comorbid Diagnoses.
|Indicator:||ICU Diagnostic Categories by APACHE II|
|Start Date:||Oct 2016|
|Reports:||No reports on this wiki list this as an indicator.|
- Default form:
How to Determine the Diagnosis Category For each Patient
- Each disease category or diagnosis leading to ICU admission has an associated weight in the model and varies for non-operative and post-operative patients.
- Post-operative patients are those with Previous Location either Operating Room or Recovery Room.
- There are weights for specific diagnosis categories and for major organ systems. The specific diagnosis category leading to ICU admission will first be determined based on the priority list in the descending order of the weights and if found none, then the major organ system following the priority list also in descending order will be used instead.
- For non-operative patients, there are 24 specific diagnosis categories while 18 for post-operative patients; total of 42 which are shown in the S_ICD10_APACHE_Dx_patterns table.
- There are 5 major vital organ system for both non-operative and post-operative patients (e.g. Nuerological, Cardiovascular, Respiratory, Gastrointestinal, Metabolic/renal) and all others NOS.
- The diagnosis having the highest weight is assigned to the patient.
- The 42 diagnosis categories are further grouped into eight major diagnostic categories for reporting purposes namely:
- Respiratory Disorders, Cardiac Disease, Post Cardiac Arrest, Neurologic Disorders,
- Trauma and Poisoning, Post-Operative Care, Metabolic/Renal/GI/Hypovolemic Shock, Sepsis and Septic Shock
- The 8 major categories are included in S_ICD10_APACHE_Dx_patterns table.
ICD10 Mapping of Diagnosis Category
- Before Jan 2019, Drs. Carla Chrusch and Kendiss Olafson did the mapping of the old admit diagnosis coding to the diagnosis categories included in the model.
- Starting Jan 2019, Dr. Allan Garland did the mapping of the admit ICD10 codes and CCI codes to the diagnosis categories included in the model.
- The list of admit diagnosis ICD10 codes is shown in APACHE Acute Dxs in ICD10 codes
Implementation in CCMDB
draws on the
The contents of the
are then used by the
to provide the list of ICD10 APACHE Acute Diagnoses for patient records.
For a list of these diagnoses on this wiki, see
For a list of these CCI procedures on this wiki, see
Notes from reviewing the list
Allan updated the original list and documented some reasons for decisions at item 13 in Task Team Meeting - Rolling Agenda and Minutes 2022#ICU Database Task Group Meeting – July 13, 2022.
Reporting of the Eight Major Diagnostic Categories
- Reported as counts and percentage by unit and time period
- Graphically as stackable vertical bar chart
- Time period - quarterly
- Critical Care Directors and Site Managers
- Critical Care Quality Improvement Team (QIT)