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18th Edition (August 5, 2011)


Home Criteria Critical Care The APACHE II Severity of Disease Classification System


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The APACHE II Severity of Disease Classification System Print E-mail
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Written by G. Firman MD   
Friday, 20 February 2009 10:12

 

 

Chronic Health Points: If the patient has a history of severe organ system insufficiency or is immunocompromised as defined below, assign points as follows:

  • 5 points for nonoperative or emergency postoperative patients
  • 2 points for elective postoperative patients


Definitions: organ insufficiency or immunocompromised state must have been evident prior to this hospital admission and conform to the following criteria:

  • Liver – biopsy proven cirrhosis and documented portal hypertension; episodes of past upper GI bleeding attributed to portal hypertension; or prior episodes of hepatic failure/encephalopathy/coma.
  • Cardiovascular – New York Heart Association Class IV.
  • Respiratory – Chronic restrictive, obstructive, or vascular disease resulting in severe exercise restriction (i.e., unable to climb stairs or perform household duties; or documented chronic hypoxia, hypercapnia, secondary polycythemia, severe pulmonary hypertension (>40 mmHg), or respirator dependency.
  • Renal – receiving chronic dialysis.
  • Immunocompromised – the patient has received therapy that suppresses resistance to infection (e.g., immunosuppression, chemotherapy, radiation, long term or recent high dose steroids, or has a disease that is sufficiently advanced to suppress resistance to infection, e.g., leukemia, lymphoma, AIDS).


Interpretation of Score:

Score

Death Rate (%)

0-4

4

5-9

8

10-14

15

15-19

25

20-24

40

25-29

55

30-34

75

>34

8

 

References:

  1. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985 Oct;13(10):818-29  [Medline]


Created: Mar 13, 2007

Last Updated on Wednesday, 21 December 2011 07:49
 

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