APACHE II Score. Used to determine the risk of death in ICU patients. Estimates ICU mortality
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.
Chronic organ insufficiency or immunocompromise history:
- Yes (+ s/p emergency surgery): +6 points
- Yes (+ s/p elective surgery): +2 points
- Yes (but not post-op): +5 points
- No: 0 points
Acute Renal Failure:
- Yes: +1 point
- No: 0 points
Mean Arterial Pressure (mm Hg)
Heart Rate/Pulse (beats per minute)
Respiratory Rate (breaths per minute)
White Blood Cell Count (cells/µL)
Glasgow Coma Scale (points)
A-a Gradient (if FiO2 ≥ 0.5) (mm Hg)
PaO2 (if FiO2 < 0.5)
The following defines “chronic organ insufficiency” and immunocompromised:
- 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.
- New Heart Association Class IV Heart Failure
- 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.
- Receiving chronic dialysis
- 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.