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.

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.


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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.

JALT

    • The list of admit CCI procedures used in combination with the admit ICD10 codes is shown in
      • There are many questions about that list, I have emailed Julie and Allan for more info. Ttenbergen 16:38, 2022 June 15 (CDT)
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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?
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  • action: no action date
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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

same as above

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  • action: no action date
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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

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