APACHE II ("Acute Physiology and Chronic Health Evaluation II") is the severity-disease classification system (Knaus et al., 1985), one of several ICU assessment systems. This is applied within 24 hours from patient admissions to intensive care unit (ICU): integer scores from 0 to 71 are calculated based on multiple measurements; higher scores are associated with more severe disease and a higher risk of death. The first APACHE model was presented by Knaus et al. in 1981.
Video APACHE II
Apps
APACHE II is designed to measure the severity of disease for adult patients treated in intensive care units. It has not been validated for use in children or adolescents under the age of 16.
This assessment system is used in many ways including:
- Some procedures or drugs are only given to patients with certain APACHE II scores
- The APACHE II score can be used to describe the patient's morbidity when comparing results with other patients.
- Mean predicted mortality for the patient group to determine group morbidity.
Although newer scoring systems, such as SAPS II, have replaced APACHE II in many places, APACHE II continues to be widely used because of the vast amount of documentation based on it.
Maps APACHE II
Calculation
Points scores were calculated from patient age and 12 routine physiological measurements:
- AaDO2 or PaO2 (depending on FiO2)
- Temp (rectal)
- Means arterial pressure
- arterial pH
- Heart rate
- Respiratory rate
- Sodium (serum)
- Potassium (serum)
- Creatinine
- Hematocrit
- Number of white blood cells
- Glasgow Coma Scale
This is measured during the first 24 hours after admission, and is used in addition to information on previous health status (recent surgery, history of severe organ insufficiency, immunocompromised state) and baseline demographics such as age. The calculation method is optimized for paper schemes, using integer values ​​and reducing the number of options so that the data fits on a single sheet paper form.
Scores are not recalculated during stay; it is the definition of acceptance score. If a patient leaves the ICU and is admitted again, a new APACHE II score is calculated.
In an original research paper describing the APACHE II score (see reference), the patient's prognosis (in particular, prediction of death) was calculated based on the APACHE II patient score in combination with the primary diagnosis at admission.
APACHE III
A method for calculating the fine score known as APACHE III was published in 1991.
The score was validated on a dataset of 17,440 adults intensive medical/surgical unit (ICU) care at 40 US hospitals.
The APACHE III prognostic system has two options:
- Apache Score III
- This provides the initial risk classification of hospitalized patients who are severely ill in a particular group.
- APACHE III predictive equation
- It uses APACHE III Scores with a number of additional variables including the main reason for admission to the ICU (from the list of references 212 conditions classified according to the etiology, major organs involved, and differences between the surgical/medical categories); age, sex, race and comorbidity already exists; and location prior to admission to ICU (operating room, recovery or emergency department, transfer or re-registration from other hospital or ICU).
Where possible, data on the time interval between patient arrivals to hospital and ICU admission times is collected.
To measure the severity of disease, 20 physiological variables were selected.
APACHE III scores range from 0 to 299.
Glasgow Coma Reform parameters to eliminate almost identical scores for different neurological signs will give better and more reliable results.
See also
- ASA physical classification system
- Glasgow Coma Scale (used by APACHE II)
References
External links
- APACHE II script calculator in Python 3.4. (licensed under GPL 3.0)
- Microsoft Excel serves to calculate APACHE II scores
- Website commonly used to calculate APACHE II scores with visual representations of predicted mortality
Source of the article : Wikipedia
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