Admit Type for APACHE II
The Admit Type for APACHE II is a way to classify patients surgical status. It is one of the elements used to generate the APACHE score. The possible values are stored in S AP AdmitType.
Note: This is not for Registry Patient Type which is part of registry screen.
As with all APACHE items, the assessment is made during the first 24hrs in the ICU.
Data Definition/Clarification
Clarification is for the purpose of uniform application of definition at all data collection sites. There is a discrepancy in the selection of admit type for APACHE for the ICU. Those patients that are "urgent surgery" in particular seem to be an issue. Some collectors are including urgent surgery with the emergency surgery group, others as are including them with the elective surgery group. "Urgent" surgery is to be coded as part of the elective surgery group. To classify a patient, follow this chart:
File:Patient Type Flowchart.gif
Discussion
The classification has to be consistent for proper scoring. Some collectors had been including urgent surgery under emergency surgery category while others were including it under elective surgery category.
- I know we have talked about this but can you define "immediate" in "immediate surgery essential for pt survival"MWaschuk 14:14, 17 June 2008 (CDT)
- adverb at once, now, instantly, straight away, directly, promptly, right now, right away, there and then, speedily, rushed without delay, without hesitation, instantaneously, forthwith, pronto (informal) unhesitatingly, this instant, on the nail, this very minute, posthaste, tout de suite (French) before you could say Jack Robinson (informal)now or without waiting; at once; without delay or hesitation; with no time interveningTOstryzniuk 14:42, 17 June 2008 (CDT)
- I will look into a more helpful definition for this. --Tina 17 June 2008
- adverb at once, now, instantly, straight away, directly, promptly, right now, right away, there and then, speedily, rushed without delay, without hesitation, instantaneously, forthwith, pronto (informal) unhesitatingly, this instant, on the nail, this very minute, posthaste, tout de suite (French) before you could say Jack Robinson (informal)now or without waiting; at once; without delay or hesitation; with no time interveningTOstryzniuk 14:42, 17 June 2008 (CDT)
- there is considerable variation in the definition of "urgency" I will look around and see which one we want to adopt and conform to for the purpose of APACHE II.TOstryzniuk 20:55, 15 December 2008 (CST)
- APACHE II's original definition is as follows (no specific time lines were included in definition):
- there is considerable variation in the definition of "urgency" I will look around and see which one we want to adopt and conform to for the purpose of APACHE II.TOstryzniuk 20:55, 15 December 2008 (CST)
- Emergency Surg - surgery that is required immediately to prevent life threatening complications.
- Elective Surg -patient can wait for scheduled in for the surgery.(no time lines for the various degrees of urgencies within the elective group).
Current suggestion for urgency time lines for APACHE II patient TYPE
- Emergency Surgery Category - to OR within <= 30 mins.
- Elective Surgery Category - to OR, >= 30 mins. (includes subcategories of elective surgery: urgent (30 mins to 4 hrs) semi urgent (4-24 hrs) and non urgent surgery (>24 hrs))
- I will submit this definition to the database committee and see if this is the one we want to adopt for APACHE II. This one is a worldwide definition used by the cardio-thoracic community but it is in variance with other national definitions, however it is simple and clear.TOstryzniuk 21:34, 15 December 2008 (CST)
- I am not sure if the Hospitals in the city have adopted a standard operating definition of emergency surgery. I know they have categories and subcategories of Elective types but I have not found out if they have assigned specific time lines to each group or not?TOstryzniuk 21:41, 15 December 2008 (CST)