APACHE Scoring table: Difference between revisions

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== Physiological Variables ==
== Physiological Variables ==
MAX score = 48
{{#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
}}


''see [[Field Ranges and Decimal Settings]] for maximum and extreme ranges''
== 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]]


{| border="1" class="wikitable"
=== number of decimal points in definitions ===
|- align="center" style="background-color:#CCCCE6;font-weight:bold"
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.
| variable
This is solved by rounding the value to one decimal point and applying the score to that.
| Abs Min
| Warn Min
| 4
| 3
| 2
| 1
| 0
| 1
| 2
| 3
| 4
| Warn Max
| Abs Max
|- align="center"


| style="background-color:#CCCCE6" | [[Temperature]] (C)
=== [[Glasgow Coma Scale]] (GCS) ===
| 24
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.
| 25.8
*GCS = EYE point + MOTOR point + VERBAL point
| ≥41
*Neurological Points = 15 - GCS
| 39-40.9
=== Acute Physiologic Score (APS) ===
|  
APS = [[#Physiological_Variables]] points + Neurological points from GCS
| 38.5-38.9
| style="background-color:#CCCCE6" | 36-38.4
| 34-35.9
| 32-33.9
| 30-31.9
| ≤ 29.9
| 42.7
| 42.7
|- align="center"
 
 
| style="background-color:#CCCCE6" | [[Mean BP]] (mm Hg)  
| SBP 19,
 
DBP 5
| SBP 25,
 
DBP 5
| ≥160
| 130-159
| 110-129
|
| height="16" style="background-color:#CCCCE6" | 70-109
|  
| 50-69
|  
| ≤49
| SBP 308,  
 
DBP 188
| SBP 344,
 
DBP 200
|- align="center"
 
 
| height="16" style="background-color:#CCCCE6" | [[HR]] (beats per minute)
| 5
| 10
| ≥180
| 140-179
| 110-139
|  
| style="background-color:#CCCCE6" | 70-109
|  
| 55-69
| 40-54
| ≤39
| 250
| 250
|- align="center" valign="top"
 
| style="background-color:#CCCCE6" | [[RR]] (breaths per minute)
| 2
| 2
 
| ≥50
| 35-49
|  
| 25-34
| style="background-color:#CCCCE6" | 12-24
| 10-11
| 6-9
|
| ≤5
| 79
| 95
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" |  [[AaDO2]] (if [[FiO2|FiO<sub>2</sub>]] &gt;= 50%)
| *1
| *1
| ≥500
| 350-499
| 201-349
| &nbsp;
| style="background-color:#CCCCE6" | &lt;=200
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
| *1
| *1
|- align="center" valign="top"
 
 
| height="16" style="background-color:#CCCCE6" |  [[PO2]] (mm Hg) (if [[FiO2|FiO<sub>2</sub>]] &lt; 50%)
| 7
| 7
 
| &nbsp;
| &nbsp;
| &nbsp;
| &nbsp;
| style="background-color:#CCCCE6" | 70
| 61-69
| &nbsp;
| 55-60
| ≤54
| 600
| 600
|- align="center" valign="top"
 
 
| height="16" style="background-color:#CCCCE6" | [[Serum CO2]] (If no ABG)  
| 2
| 2
| ≥52
| 41-51.9
| &nbsp;
| 32-40.9
| style="background-color:#CCCCE6" | 22-31.9
| &nbsp;
| 18-21.9
| 15-17.9
| ≤14
| 59
| 59
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" | [[PH|Arterial pH]]
| 6
| 6
| ≥7.7
| 7.6-7.69
| &nbsp;
| 7.5-7.59
| style="background-color:#CCCCE6" | 7.33-7.49
| &nbsp;
| 7.25-7.32
| 7.15-7.24
| ≤ 7.14
| 7.97
| 7.99
|- align="center" valign="top"
 
| height="16" style="background-color:#CCCCE6" | [[Na]] (mmol/L)
| 70
| 100
| ≥180
| 160-179
| 155-159
| 150-154
| style="background-color:#CCCCE6" | 130-149
| &nbsp;
| 120-129
| 111-119
| ≤110
| 190
| 200


|- align="center" valign="top"
==== Inclusion of pH in absence of other ABG components ====
| height="16" style="background-color:#CCCCE6" | [[K]] (mmol/L)
include it
| 1
| 1
| ≥7
| 6-6.9
| &nbsp;
| 5.5-5.9
| style="background-color:#CCCCE6" | 3.5-5.4
| 3-3.4
| 2.5-2.9
| &nbsp;
| ≤2.4
| 9.9
| 12
 
|- align="center" valign="top"
| height="26" style="background-color:#CCCCE6" | [[Creatinine]] (mmol/L)
(*Double point if yes for [[ARF (APACHE)|ARF]])
| 2
| 5
| ≥309
| 178-308
| 133-177
| &nbsp;
| style="background-color:#CCCCE6" | 53-132
| &nbsp;
| ≤52
| &nbsp;
| &nbsp;
| 2288
| 2785
 
|- align="center" valign="top"
| height="16" style="background-color:#CCCCE6" | [[HCT]] (unit?)
| 3
| 3
| ≥60
| &nbsp;
| 50-59.9
| 46-49.9
| style="background-color:#CCCCE6" | 30-45.9
| &nbsp;
| 20-29.9
| &nbsp;
| ≤19
| 68
| 78
 
|- align="center" valign="top"
| height="16" style="background-color:#CCCCE6" | [[WBC]](?unit)
| 0.01
| 0.02
| ≥40
| &nbsp;
| 20-39.9
| 15-19.9
| style="background-color:#CCCCE6" | 3-14.9
| &nbsp;
| 1-2.9
| &nbsp;
| &lt;1
| 301
| 517
|}
 
=== *1 AaDO2 component max/min values ===
* FIO2 ranges acceptable from 21-100
* CO2 warning range 2-285, absolute range 2-440
 
=== Arterial Blood Gas (ABG) scoring ===
{{discussion}} Is the following right? If so pls remove the discussion point... Ttenbergen 11:51, 2014 January 6 (CST)
* If '''no''' ABG
** apply score only for the SerCO2
** '''ignore pH component?'''
* else (ie. ABG present)
** apply pH score
** if FIO2 >= 50
*** apply AaDO2 score
** else (ie FIO2 < 50)
*** apply PO2 score
 
== [[Glasgow Coma Scale]] (GCS) ==
For information on collecting and coding the values, see the [[Glasgow Coma Scale]] article.


== [[Age]] Points ==
== [[Age]] Points ==
Line 290: Line 72:


== Chronic Health Score ==
== 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:


The chronic health score is calculated from [[Chronic Health APACHE]] and [[Admit Type for APACHE II]].
=== 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


The chronic health score is generated as follows:
==Total Apache Score==
{| class="wikitable" border=1
TotApache = APS + Chronic Health points+ agepts
|-
|style="background-color:#CCCCE6"| Points|| Chronic Health Status
|-
|style="background-color:#CCCCE6"| 0|| No history of chronic disease


|-
TotApache MAX =74
|style="background-color:#CCCCE6"| 2|| Elective Post op with history of chronic disease


|-
== Related articles ==
|style="background-color:#CCCCE6"| 5|| Non OP (medical) or emergency post op with history of chronic disease
{{Related Articles}}
 
|}
 
{{Discussion}}
* Following this table will lead to an '''undefined result''' if the patient AT = Medical and Chronic <> None; that makes me think this is not how this is really implemented in TMSX. How is it? Ttenbergen 16:19, 2014 January 2 (CST)
 
==Total Apache Score==
TotApache = APS + GCS + Chronic Health points+ agepts


===APSpts-Acute Physiological Points===
APS= scores Apache items 1 to 11 + GCS


{{discussion}}
Does that mean that TotApache effectively uses the GCS parameter twice? The preceeding 2 formulas would make me think so... Ttenbergen 10:57, 2014 January 6 (CST)


[[Category:APACHE II]]
[[Category:APACHE II | *]]
[[Category:APACHE II Physiological Variables]]
[[Category:APACHE II Physiological Variables | *]]
[[Category:ABG]]
[[Category:ABG]]

Latest revision as of 13:48, 2023 May 4

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

MAX score = 48

 AP phys nameAP phys unitAP phys absMaxAP phys warnMaxAP H4AP H3AP H2AP H1AP 0AP L1AP L2AP L3AP L4AP phys warnMinAP phys absMin
AaDO2Alveolar-arterial oxygen tension difference>500>=350 and <500>=200 and <350<200
AP Dias BP FieldDiastolic blood pressuremmHG200128as per Mean BP2515
HRHeart Ratebeats/min205250>=180>=140 and <180>=110 and <140>=70 and <110>=55 and <70>=40 and <55<40105
KPotassiummmol/L129.9=>7>=6 and <7>=5.5 and <6>=3.5 and <5.5>=3 and <3.5>=2.5 and <3<2.511
Serum CO2Serum CO2mmol/L440285≥52>=41 and <52>=32 and <41>= 22 and <32>=18 and <22>=15 and <18<1522
NaSodiummmol/L200190>=180>=160 and <180>=155 and <160>=150 and <155>=130 and <150>=120 and <130>=111 and <120≤11110070
AP Sys BP FieldSystolic Blood PressuremmHG360243as per Mean BP4925
TemperatureTemperature°C42.742.7>=41>=39 and <41>=38.5 and <39>=36 and <38.5>=34 and <36>=32 and <34>=30 and <32<3011
WBCWhite Blood Countx109/L517301>=40>=20 and <40>=15 and <20>=3 and <15>=1 and <3<10.020.01
FiO2fraction of inspired oxygenpercentage100100as per AaDO22020
HCThematocritpercentage33>=60>=50 and <60>=46 and <50>=30 and <46>=20 and <30<206878
Mean BPmean blood pressuremmHG>=160>=130 and <160>=110 and <130>=70 and <110>=50 and <70<49
PCO2partial pressure of carbon dioxide in arterial bloodmmol/L440285AaDO222
PO2partial pressure of oxygenmmHG650650>=70>=60 and <70>=55 and <60<5543
PHph7.997.97>=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<7.1566
RRrespiratory ratebreaths/min9579>=50>=35 and <50>=25 and <35>=12 and <25>=10 and <12>=6 and <10<622
Creatinine (APACHE)serum creatinineµmol/L>=309>=178 and <309>=133 and <178>=53 and <133≤5252

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

Acute Physiologic Score (APS)

APS = #Physiological_Variables points + Neurological points from GCS

Inclusion of pH in absence of other ABG components

include it

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

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

Total Apache Score

TotApache = APS + Chronic Health points+ agepts

TotApache MAX =74

Related articles

Related articles: