APACHE II ("Acute Physiology and Chronic Health Evaluation II") is a severity-of-disease classification system (Knaus et al., 1985)[1], one of several ICU scoring systems. It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death
APACHE II was designed to measure the severity of disease for adult patients admitted to Intensive care units. The lower age bound is not specified in the original article, but a good limit is to use Apache II only for patients aged 15 or older[citation needed].
This scoring system is used in many ways:
Some procedures and some medicine is only given to patients with a certain APACHE II score
APACHE II score can be used to describe the morbidity of a patient when comparing the outcome with other patients.
Predicted mortalities are averaged for groups of patients in order to specify the group's morbidity.
Even though newer scoring systems, such as SAPS II, have replaced APACHE II in many places, APACHE II continues to be used extensively because so much documentation is based on it.
[edit] CalculationThe point score is calculated from 12 routine physiological measurements, such as blood pressure, body temperature, heart rate, etc., during the first 24 hours after admission, information about previous health status, and some information obtained at admission (such as age). The calculation method is optimized for paper schemas, by using integer values and reducing the number of options so that data fit on a single-sheet paper form. The resulting point score should always be interpreted in relation to the illness of the patient.
The score is not recalculated during the stay—it is by definition an admission score. If a patient is discharged from the ICU and readmitted, a new APACHE II score is calculated.
The appendix of the document (see references) that originally described the APACHE II score, attempts to describe how to calculate a predicted death rate for a patient. In order to improve the accuracy of this calculation of predicted mortality, the principal diagnosis leading to ICU admission was added as a category weight: the predicted mortality is computed based on the patient's APACHE II score and their principal diagnosis at admission
APACHE II Calculator
Age:
--------------------------------------------------------------------------------
Hematocrit:
WBC:
Temp:
MAP
Heart Rate:
Respiratory Rate:
Serum Sodium(meq/L)
Serum K+(meq/L)
Aa Gradient / FiO2
Arterial pH:
SCR (mg/dl):
--------------------------------------------------------------------------------
GCS[/left]
Units: US SI APACHE II Score for ICU Mortality
Does the patient have a history of chronic organ insufficiency or immunocompromise? Yes, and is s/p emergency surgery.
Yes, but is not s/p operation.
Yes, and is s/p elective surgery.
No.
Does the patient have acute renal failure? Yes.
Age years old
Temperature (Rectal, Celsius) °C or °F (yes, either!)
Mean Arterial Pressure (MAP)
pH (Arterial)
Heart Rate bpm
Respiratory Rate (either ventilated or spontaneous) bpm
Sodium (Serum) mg/dL
Potassium (Serum) mg/dL
Creatinine (Serum) mg/dL
Hematocrit
White Blood Cell Count x103 cells / mm3
Glasgow Coma Score points
A-a Gradient (if FiO2 ≥ 0.5) mm Hg
PaO2 (if FiO2 < 0.5) mm Hg
ApacheII Score points [/left]
APACHE II was designed to measure the severity of disease for adult patients admitted to Intensive care units. The lower age bound is not specified in the original article, but a good limit is to use Apache II only for patients aged 15 or older[citation needed].
This scoring system is used in many ways:
Some procedures and some medicine is only given to patients with a certain APACHE II score
APACHE II score can be used to describe the morbidity of a patient when comparing the outcome with other patients.
Predicted mortalities are averaged for groups of patients in order to specify the group's morbidity.
Even though newer scoring systems, such as SAPS II, have replaced APACHE II in many places, APACHE II continues to be used extensively because so much documentation is based on it.
[edit] CalculationThe point score is calculated from 12 routine physiological measurements, such as blood pressure, body temperature, heart rate, etc., during the first 24 hours after admission, information about previous health status, and some information obtained at admission (such as age). The calculation method is optimized for paper schemas, by using integer values and reducing the number of options so that data fit on a single-sheet paper form. The resulting point score should always be interpreted in relation to the illness of the patient.
The score is not recalculated during the stay—it is by definition an admission score. If a patient is discharged from the ICU and readmitted, a new APACHE II score is calculated.
The appendix of the document (see references) that originally described the APACHE II score, attempts to describe how to calculate a predicted death rate for a patient. In order to improve the accuracy of this calculation of predicted mortality, the principal diagnosis leading to ICU admission was added as a category weight: the predicted mortality is computed based on the patient's APACHE II score and their principal diagnosis at admission
APACHE II Calculator
Age:
--------------------------------------------------------------------------------
Hematocrit:
WBC:
Temp:
MAP
Heart Rate:
Respiratory Rate:
Serum Sodium(meq/L)
Serum K+(meq/L)
Aa Gradient / FiO2
Arterial pH:
SCR (mg/dl):
--------------------------------------------------------------------------------
GCS[/left]
Units: US SI APACHE II Score for ICU Mortality
Does the patient have a history of chronic organ insufficiency or immunocompromise? Yes, and is s/p emergency surgery.
Yes, but is not s/p operation.
Yes, and is s/p elective surgery.
No.
Does the patient have acute renal failure? Yes.
Age years old
Temperature (Rectal, Celsius) °C or °F (yes, either!)
Mean Arterial Pressure (MAP)
pH (Arterial)
Heart Rate bpm
Respiratory Rate (either ventilated or spontaneous) bpm
Sodium (Serum) mg/dL
Potassium (Serum) mg/dL
Creatinine (Serum) mg/dL
Hematocrit
White Blood Cell Count x103 cells / mm3
Glasgow Coma Score points
A-a Gradient (if FiO2 ≥ 0.5) mm Hg
PaO2 (if FiO2 < 0.5) mm Hg
ApacheII Score points [/left]
Mon May 08, 2023 3:14 pm by yagocom
» ultrasound of lung in critical care patients
Mon Apr 24, 2023 9:50 am by yagocom
» respiratory diseases , anaesthetic management 2023
Sat Feb 18, 2023 6:42 pm by yagocom
» thoracic anaesthesia 2023
Fri Feb 10, 2023 10:43 pm by yagocom
» indication to SICU admission
Sun Nov 20, 2022 3:21 pm by yagocom
» electrolyte disturbances
Sat Jul 23, 2022 11:11 pm by yagocom
» fluid physiology
Mon Jul 11, 2022 12:09 pm by yagocom
» TAP block USG
Mon Jul 11, 2022 11:56 am by yagocom
» Assisted ventilation for surgical patients
Fri Jul 08, 2022 10:40 am by yagocom
» nutrition in critical ill patient
Sun Jun 12, 2022 11:14 pm by yagocom
» US workshop in Mosul
Fri May 27, 2022 2:56 pm by yagocom
» Basics of ultrasound
Fri May 27, 2022 2:28 pm by yagocom
» الملتقى العلمي الاول للجمعية العراقية للتخدير والعناية المركزة والحد من الالم فرع الموصل
Mon May 09, 2022 7:15 pm by yagocom
» Geriatric anaesthesia
Sun May 08, 2022 10:35 pm by yagocom
» thoracic anaesthesia 2022
Sat Jan 15, 2022 11:14 pm by yagocom
» chronic pain management
Fri Dec 03, 2021 5:53 pm by yagocom
» anaesthesia in respiratory diseases
Mon Nov 29, 2021 8:33 pm by yagocom
» anaesthesia for plastic procedures
Mon Jul 19, 2021 11:17 am by yagocom
» ECG for candidate
Mon Jul 19, 2021 11:14 am by yagocom
» postoperative care
Tue Feb 23, 2021 10:50 pm by yagocom