From the Guidelines
The Acute Physiology and Chronic Health Evaluation (APACHE) II scale describes a severity of illness scoring system that evaluates a patient's chronic health status and 12 physiologic measurements.
Key Components of APACHE II
- The scale is not specific to any particular disease or condition, but rather provides a general assessment of a patient's severity of illness
- It takes into account both premorbid factors, such as patient age and chronic medical conditions, as well as acute changes in physiologic parameters 1
- The 12 physiologic measurements included in the APACHE II score are not specified in the provided evidence, but it is mentioned that the score is based on a combination of patient demographics, clinical features, laboratory parameters, and imaging modalities 1
Clinical Application of APACHE II
- The APACHE II score can be used to predict mortality and guide treatment strategies for patients with complicated intra-abdominal infections, among other conditions 1
- Risk groups based on APACHE II scores can be categorized into "low" (0-10), "intermediate" (11-15), and "high" (>15), with predicted mortality rates varying accordingly 1
- The score has been validated as a widely used instrument, but has disadvantages such as being cumbersome and not all parameters being routinely collected 1
From the Research
Overview of APACHE II Scale
- The Acute Physiology and Chronic Health Evaluation (APACHE) II scale is a severity of disease classification system that uses a point score based on initial values of 12 routine physiologic measurements, age, and previous health status to provide a general measure of severity of disease 2.
- The scale is used to evaluate the severity of illness in critically ill patients and can be used to predict hospital mortality 3, 4.
- The APACHE II score ranges from 0 to 71, with higher scores indicating a higher risk of hospital death 2.
Components of APACHE II Scale
- The APACHE II scale includes 12 physiological variables, such as temperature, mean arterial blood pressure, and heart rate 2.
- The scale also takes into account the patient's age and previous health status 2.
- The Glasgow Coma Scale (GCS) is also included in the APACHE II system 5.
Uses of APACHE II Scale
- The APACHE II scale can be used to prognostically stratify acutely ill patients and assist investigators in comparing the success of new or differing forms of therapy 2.
- The scale can also be used to evaluate the use of hospital resources and compare the efficacy of intensive care in different hospitals or over time 2.
- APACHE II has been shown to be effective in predicting mortality in head-injured patients with systemic trauma, and is superior to the GCS in this regard 5.
- The optimal time point for obtaining the APACHE II score to predict hospital mortality is on day 3 of hospitalization, with a cut-off score of 17 4.