APACHE Acute Diagnoses: Difference between revisions

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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)]].   
{{Reporting Indicators
|description =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]].
This is not about [[Chronic Health APACHE]] or the [[APACHE Comorbid Diagnoses]].
 
| indicator_name = ICU Diagnostic Categories by APACHE II
| created_raw = Created 
| program = Critical Care
| indicator_start_date = Oct 2016
| indicator_end_date =
}}
== How to Determine the Diagnosis Category For each Patient ==
== 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.
*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.
** 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.
*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.
**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.
**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 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 ==
== 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.
*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.
*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]]
**The list of admit diagnosis ICD10 codes is shown in [[APACHE Acute Dxs in ICD10 codes]]
**the list of admit  CCI procedures used in combination with the admit ICD10 codes is shown  in  [[ to be done by TT]] 
 
{{DJ| to be continued by JM }}
The {{PAGENAME}} is a component of the [[APACHE Score]]. This is not collected specifically, but instead assigned behind the scenes based on whether any of the Admit Diagnosis is on a list of diagnoses that correspond to the diagnoses in the original Apache study.


== Implementation in CCMDB ==
== Implementation in CCMDB ==
Line 36: Line 42:
* [[APACHE Acute Dxs in ICD10 codes]]
* [[APACHE Acute Dxs in ICD10 codes]]


{{Discuss | who = Julie | question = * You and Allan discussed what should be on the list. At some point we will need to integrate the result into this query. Did you end up including Acquireds? Since the first 24hrs might include them, but they might happen later, and the difference is not clear from [[Dx_Date]]? Ttenbergen 20:20, 2018 November 24 (CST)
For a list of these CCI procedures on this wiki, see
** is this the list which Allan gave about the APACHE Comorbids conditions namely liver, cardiovascular, respiratory, renal and immunocompromised?  allan said exclude the admits and include only the comorbids. but we still have to discuss the comparative results. --[[User:JMojica|JMojica]] 16:45, 2022 February 16 (CST)  
=== Notes from reviewing the list ===
*** No, that is [[L ICD10 APACHE Comorbids query]], this is about the  [[APACHE Acute Diagnoses]] used in [[APACHE Score]]. [[User:Ttenbergen|Ttenbergen]] 19:44, 2022 February 17 (CST)  
{{TT | just Tina's working notes:
***sent email to Tina today to clarify this. --[[User:JMojica|JMojica]] 17:04, 2022 April 6 (CDT)
Scenarios:
**** emailed Julie with clarification. [[User:Ttenbergen|Ttenbergen]] 09:33, 2022 April 14 (CDT)
* one of a * of ICD10s
}}
* one of a * of ICD10s AND one of a * of ICD10s
* one of a * of ICD10s AND an ICD10 with a word in it
* one of a * of ICD10s AND one of a * of CCIs
* one of a * of CCIs
* two or more of a * of ICD10s
 
AND any admit procedure is EITHER:
(a) of the form 1.AA.xx, 1.AB.xx, 1.AC.xx, 1.AE.xx, 1.AD.xx, 1.AG.xx, 1.AJ.xx, 1.AK.xx, 1.AN.xx, 1.AP.xx
::     where “xx” {{=}} any of 13, 51, 52, 53, 56, 57, 59, 72, 76, 80, 87, 89, 90, 91
or
(b) 2.AA.71.yy, 2.AB.71.yy, 2.AC.71.yy, 2.AE.71.yy, 2.AD.71.yy, 2.AG.71.yy, 2.AJ.71.yy, 2.AK.71.yy, 2.AN.71.yy, 2.AP.71.yy
::     where “yy” {{=}} any of 70.^, 71.^
 
* one of a * of ICD10s AND (one of * of CCI1 and a * of CCI2)
** might be able to do a pattern recognition on that? Or a regular expression?
 
}}
 
{{TT |
* I will need to re-think how these are documented on the wiki as well, as the current schema was based on individual dxs meeting criteria and this is quite different. [[User:Ttenbergen|Ttenbergen]] 10:39, 2022 November 15 (CST)
}}
 
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
 
==Report Users==
*Critical Care Directors and Site  Managers
*Critical Care Quality Improvement Team (QIT)


== further on this wiki ==
==SAS Program==
*S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\1-prepCC_QI_startJan2022.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ICD10_ApachePredHospMort_byPriority.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\3-prepCCChart_ApacheDxGrp_94_startJan2020.sas


== Related Articles ==
== Related Articles ==

Latest revision as of 11:39, 2022 November 15

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.

Indicators
Indicator: ICU Diagnostic Categories by APACHE II
Created/Raw: Created
Program: Critical Care
Start Date: Oct 2016
End Date:
Reports: No reports on this wiki list this as an indicator.


  • Cargo


  • SMW:
  • Categories
  • 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

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.

Implementation in CCMDB

The

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

just Tina's working notes: Scenarios:

  • one of a * of ICD10s
  • one of a * of ICD10s AND one of a * of ICD10s
  • one of a * of ICD10s AND an ICD10 with a word in it
  • one of a * of ICD10s AND one of a * of CCIs
  • one of a * of CCIs
  • two or more of a * of ICD10s

AND any admit procedure is EITHER: (a) of the form 1.AA.xx, 1.AB.xx, 1.AC.xx, 1.AE.xx, 1.AD.xx, 1.AG.xx, 1.AJ.xx, 1.AK.xx, 1.AN.xx, 1.AP.xx

where “xx” = any of 13, 51, 52, 53, 56, 57, 59, 72, 76, 80, 87, 89, 90, 91

or (b) 2.AA.71.yy, 2.AB.71.yy, 2.AC.71.yy, 2.AE.71.yy, 2.AD.71.yy, 2.AG.71.yy, 2.AJ.71.yy, 2.AK.71.yy, 2.AN.71.yy, 2.AP.71.yy

where “yy” = any of 70.^, 71.^
  • one of a * of ICD10s AND (one of * of CCI1 and a * of CCI2)
    • might be able to do a pattern recognition on that? Or a regular expression?
  • added: no added date
  • action: no action date
  • Cargo


  • Categories
  • I will need to re-think how these are documented on the wiki as well, as the current schema was based on individual dxs meeting criteria and this is quite different. Ttenbergen 10:39, 2022 November 15 (CST)
  • added: no added date
  • action: no action date
  • Cargo


  • Categories

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

Report Users

  • Critical Care Directors and Site Managers
  • Critical Care Quality Improvement Team (QIT)

SAS Program

  • S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\1-prepCC_QI_startJan2022.sas
  • S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ICD10_ApachePredHospMort_byPriority.sas
  • S:\MED\MED_CCMED\Julie\SAS_CFE\CC_reports\ChartReport\3-prepCCChart_ApacheDxGrp_94_startJan2020.sas

Related Articles

Related articles:
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