APACHE Scoring table

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

see Field Ranges and Decimal Settings for maximum and extreme ranges

variable	Abs Min	Warn Min	4	3	2	1	0	1	2	3	4	Warn Max	Abs Max
Temperature (C)	24	25.8	≥41	39-40.9		38.5-38.9	36-38.4	34-35.9	32-33.9	30-31.9	≤ 29.9	42.7	42.7
Mean BP (mm Hg)	SBP 19, DBP 5	SBP 25, DBP 5	≥160	130-159	110-129		70-109		50-69		≤49	SBP 308, DBP 188	SBP 344, DBP 200
HR (beats per minute)	5	10	≥180	140-179	110-139		70-109		55-69	40-54	≤39	250	250
RR (breaths per minute)	2	2	≥50	35-49		25-34	12-24	10-11	6-9		≤5	79	95
AaDO2 (if FiO2 >= 50% - *2)	*1	*1	≥500	350-499	200-349		<200					*1	*1
PO2 (mm Hg) (if FiO2 < 50% - *2)	7	7					>70	61-70		55-60	≤54	600	600
Serum CO2 (If no ABG) - *2	2	2	≥52	41-51.9		32-40.9	22-31.9		18-21.9	15-17.9	<15	59	59
Arterial pH - *2	6	6	≥7.7	7.6-7.69		7.5-7.59	7.33-7.49		7.25-7.32	7.15-7.24	< 7.15	7.97	7.99
Na (mmol/L)	70	100	≥180	160-179	155-159	150-154	130-149		120-129	111-119	≤110	190	200
K (mmol/L)	1	1	≥7	6-6.9		5.5-5.9	3.5-5.4	3-3.4	2.5-2.9		<2.5	9.9	12
Creatinine (mmol/L) (*Double point if yes for ARF go to: Definition for ARF for APACHE II)	2	5	≥309	178-308	133-177		53-132		≤52			2288	2785
HCT (%)	3	3	≥60		50-59.9	46-49.9	30-45.9		20-29.9		<20	68	78
WBC(x10 9/L)(*3)	0.01	0.02	≥40		20-39.9	15-19.9	3-14.9		1-2.9		<1	301	517

*1 AaDO2 component max/min values

• FIO2 ranges acceptable from 21-100
• CO2 warning range 2-285, absolute range 2-440

*2 - Arterial Blood Gas (ABG) scoring

• 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

*3 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

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

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:

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

-Trish Ostryzniuk 20:00, 2014 January 27 (CST)

Total Apache Score

TotApache = APS #Physiological_Variables points + Neurological points from GCS + Chronic Health points+ agepts

APSpts - Acute Physiological Points

APS = scores as per #Physiological_Variables