APACHE II Score for ICU Mortality

Calculates the APACHE-II score to estimate predicted mortality.

Does the patient have a history of chronic organ insufficiency or immunocompromise?
Does the patient have acute renal failure?
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)
Potassium (Serum)
Creatinine (Serum)
Hematocrit
White Blood Cell Count x103 cells / mm3
Glasgow Coma Score points
A-a Gradient (if FiO2 ≥ 0.5)
PaO2 (if FiO2 < 0.5)
Apache II Score points

The Apache-II Score provides an estimate of ICU mortality based on a number of laboratory values and patient signs taking both acute and chronic disease into account. Note: The data used should be from the initial 24 hours in the ICU, and the worst value (furtherest from baseline/normal) should be used.

The following defines "chronic organ insufficiency" and immunocompromise:

  • Liver insufficiency
    • Biopsy proven cirrhosis
    • Documented portal hypertension
    • Episodes of past upper GI bleeding attributed to portal hypertension
    • Prior episodes of hepatic failure / encephalopathy / coma.
  • Cardiovascular
    • New Heart Association Class IV Heart Failure
  • Respiratory
    • Chronic restrictive, obstructive or vascular disease resulting in severe exercice restriction, i.e. unable to climb stairs or perform household duties.
    • Documented chronic hypoxia, hypercapnia, secondary polycythemia , severe pulmonary hypertension (> 40 mmHg), or respirator dependency.
  • Renal
    • Receiving chronic dialysis
  • Immunosuppression
    • The patient has received therapy that suppresses resistance to infection e.g. immuno-suppression, chemotherapy, radiation, long term or recent hight dose steroids, or has a disease that is sufficiently advanced to suppress resistance to infection, e.g. leukemia, lymphoma, AIDS.

Posted in: Critical Care









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