APACHE II Scoring System – Aerolib Tools

Glasgow Coma Score

Chronic Health Problems: 1) Cirrhosis of the liver confirmed by biopsy 2) New York Heart Association Class IV 3) Severe COPD -- Hypercapnia, home O2 use, or pulmonary hypertension 4) On regular dialysis or 5) Immunocompromised

None (0 points)

Non-Surgical (5 points)

Emergent operation (5 points)

Elective operation (2 points)

Total Criteria Point Count:

* Required

Apache II Score / Approximate Mortality Interpretation

0-4: 4% non-op, 1% post-op 5-9: 8% non-op, 3% post-op 10-14: 15% non-op, 7% post-op 15-19: 24% non-op, 12% post-op 20-24: 40% non-op, 30% post-op 25-29: 55% non-op, 35% post-op 30-34: Approx 73% both 35-100: 85% non-op, 88% post-op

Notes

For the APACHE II score to be correct, a value must be selected for every variable.
The numbers in the parentheses represent the point value assigned to each clinical parameter above. The Apache Score is the sum of these points.
Chronic Dx includes biopsy proven cirrhosis and documented portal hypertension; past upper GI bleeding attributed to portal hypertension; prior hepatic failure; prior hepatic encephalopathy; NYHA class IV; chronic restrictive, obstructive, or vascular lung disease resulting in severe exercise restriction; documented hypoxemia or hypercapnia; secondary polycythemia; severe pulmonary hypertension (>40 mmHg); ventilator dependence; chronic hemodialysis.
Chronic Dx also includes immunosuppression from chemotherapy, radiation therapy, long-term or recent high-dose steroids, immunodeficiency (eg, leukemia, lymphoma, AIDS).

References

Knaus WA, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818-29.
Intensive Care Med. 2000 Dec;26(12):1779-85.Validation of severity scoring systems SAPS II and APACHE II in a single-center population. Capuzzo M1, Valpondi V, Sgarbi A, Bortolazzi S, Pavoni V, Gilli G, Candini G, Gritti G, Alvisi R.
Cancer. 1992 Jul 15;70(2):497-503.Independent validation of APACHE II severity of illness score for predicting mortality in patients with breast cancer admitted to the intensive care unit. Headley J, Theriault R, Smith TL.

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