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%)	*1	*1	≥500	350-499	201-349		<=200					*1	*1
PO2 (mm Hg) (if FiO2 < 50%)	7	7					70	61-69		55-60	≤54	600	600
Serum CO2 (If no ABG)	2	2	≥52	41-51.9		32-40.9	22-31.9		18-21.9	15-17.9	≤14	59	59
Arterial pH	6	6	≥7.7	7.6-7.69		7.5-7.59	7.33-7.49		7.25-7.32	7.15-7.24	≤ 7.14	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		≤2.4	9.9	12
Creatinine (mmol/L) (*Double point if yes for ARF)	2	5	≥309	178-308	133-177		53-132		≤52			2288	2785
HCT (unit?)	3	3	≥60		50-59.9	46-49.9	30-45.9		20-29.9		≤19	68	78
WBC(?unit)	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

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

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.

The chronic health score is generated as follows:

Points	Chronic Health Status
0	No history of chronic disease
2	Elective Post op with history of chronic disease
5	Non OP (medical) or emergency post op with history of chronic disease

• 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)
  • In TMSX, if Admit type is not Elective Surgery (e.g. Medical or Emergency) and Chronic is Yes, points=5. If Admit type is Elective Surgery (e.g. Not Medical or not Emergency) and Chronic is Yes, points=2. If Admit type is not or is Elective Surgery and Chronic is No, point=0.

Total Apache Score

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

APSpts - Acute Physiological Points

APS= scores Apache items 1 to 11

Template: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)

• No GCS in the APS
• Need to label which are items1 to 11.