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APACHE II Severity-of-disease classification system
APACHE II Severity-of-disease classification system
APACHE II Calculator
APACHE II (Acute Physiology And Chronic Health Evaluation II) is a severity-of-disease classification system with a final score of 0 to 71, with higher scores corresponding to more severe disease and a higher risk of death. It is determined within 24 hours of admission to an intensive care unit (ICU).
Age
:
< or = 44
45 - 54
55 - 64
65 - 74
> or = 75
Hematocrit
:
<20%
20 - 29.9%
30 - 45.9%
46 - 49.9%
50- 59.9%
>=60%
WBC
:
<1000
1000 - 2900
3000 - 14900
15000 - 19900
20000 - 39900
> or = 40000
Rectal Temp
:
> or = 41 °C
39 - 40.9 °C
38.5 - 38.9 °C
36 - 38.4 °C
34 - 35.9 °C
32 - 33.9 °C
30 - 31.9 °C
< or = 29.9 °C
F-->C
MAP
< or = 49
50-69
70-109
110-129
130-159
> = 160
MAP= [(2 x diastolic)+systolic] / 3
Heart Rate
:
< = 39
40-54
55-69
70-109
110-139
140-179
> = 180
Respiratory Rate
:
< or = 5
6-9
10-11
12-24
25-34
35-49
> or = 50
Serum Sodium
(meq/L)
> or = 180
160 - 179
155 - 159
150 - 154
130 - 149
120 - 129
111 - 119
< or = 110
Serum K+
(meq/L)
> or = 7.0
6 - 6.9
5.5 - 5.9
3.5 - 5.4
3 - 3.4
2.5 - 2.9
< 2.5
Calculate Aa gradient if FIO2 >or= 0.5
Aa gradient >or=500 And FIO2 > or =0.5
Aa gradient 350-499 And FIO2 >=0.5
Aa gradient 200-349 And FIO2 >=0.5
Aa gradient <200 And FIO2 >=0.5
PaO2 > 70 and FIO2 < 0.5
PaO2 61-70 and FIO2 < 0.5
PaO2 55-60 and FIO2 < 0.5
PaO2 <55 and FIO2 < 0.5
(Oxygenation)
Arterial pH
:
> or = 7.7
7.6 - 7.69
7.5 - 7.59
7.33- 7.49
7.25 - 7.32
7.15 - 7.24
< 7.15
If NO ABG data use HCO3
HCO3 >= 52
HCO3 41 - 51.9
HCO3 32 - 40.9
HCO3 22 - 31.9
HCO3 18 - 21.9
HCO3 15 - 17.9
HCO3 <15
Serum Creatinine
(mg/dl):
>=3.5 AND not acute renal failure
2.0 - 3.4 AND not acute renal failure
1.5 - 1.9 AND not acute renal failure
0.6 - 1.4 AND not acute renal failure
<0.6 AND not acute renal failure
>=3.5 AND Acute Renal Failure
2.0 - 3.4 AND Acute Renal Failure
1.5 - 1.9 AND Acute Renal Failure
0.6 - 1.4 AND Acute Renal Failure
<0.6 AND Acute Renal Failure
History of severe organ insufficiency (heart, liver, kidney, other)
or immunocompromised?
No
Yes AND Non-operative patient
Yes AND emergency postoperative pt
Yes AND elective surgery postoperative
Glasgow Coma Scoring
:
Eye Opening:
Spontaneous
To Command
To Pain
No response
Verbal:
Oriented
Confused
Inappropriate
Incomprehensible
No Response
Motor:
Obeys Commands
Localizes pain
Withdraws to pain
Flexion to pain
Extension to pain
No Response
Reference
Knaus WA Draper EA et al. APACHE II: A severity of disease classification
system. Critical Care Medicine. 1985; 13 (Appendix pages 828-829)
PubMed