The APACH II score is given by the sum of the acute physiology score, the age points, and the chronic health points.
Acute Physiology Score (APS)
Sum of the following 12 individual variable points
Sum of the following 12 individual variable points
High abnormal range
|
Low abnormal range
|
||||||||
Physiological variable |
+4
|
+3
|
+2
|
+1
|
0
|
+1
|
+2
|
+3
|
+4
|
Temperature
(℃) |
> 41
|
39-40.9
|
38.5-38.9
|
36-38.4
|
34-35.9
|
32-33.9
|
30-31.9
|
< 29.9
|
|
Mean arterial pressure (mmHg) |
> 160
|
130-159
|
110-129
|
70-109
|
50-69
|
< 49
|
|||
Heart rate (ventricular response) |
> 180
|
140-179
|
110-139
|
70-109
|
55-69
|
40-54
|
< 39
|
||
Respiratory rate (non-vetilated or ventilated) |
> 50
|
35-49
|
25-34
|
12-24
|
10-11
|
6-9
|
< 5
|
||
Oxygenation: AaD (mmHg)(FiO2 > 0.5 record AaDO2, FiO2 <0.5 record PaO2)O2 O2or Pa |
> 500
|
350-499
|
200-349
|
<200
PaO2 >70 |
PaO2 61-70 |
PaO2 55-60 |
PaO2 <55 |
||
Arterial pH |
> 7.7
|
7.6-7.69
|
7.5-7.59
|
7.33-7.49
|
7.25-7.32
|
7.15-7.24
|
<7.15
|
||
Serum sodium (mmol/l) |
> 180
|
160-179
|
155-159
|
150-154
|
130-149
|
120-129
|
111-119
|
< 110
|
|
Serum potassium (mmol/l) |
> 7
|
6-6.9
|
5.5-5.9
|
3.5-5.4
|
3-3.4
|
2.5-2.9
|
< 2.5
|
||
Serum creatinine (mg/dl) (double point score for acute renal failure) |
> 3.5
|
2-3.4
|
1.5-1.9
|
0.6-1.4
|
<0.6
|
||||
Hematocrit (% ) |
> 60
|
50-59.9
|
46-49.9
|
30-45.9
|
20-29.9
|
<20
|
|||
W.B.C. (´ 102/mm3) |
> 40
|
20-39.9
|
15-19.9
|
3-14.9
|
1-2.9
|
<1
|
|||
Glasgow coma score (GCS) Score =15- actual GCS |
|||||||||
Serum HCO3 (venous-mmol/l) (not preferred, use if no ABGs) |
> 52
|
41-51.9
|
32-40.9
|
22-31.9
|
18-21.9
|
15-17.9
|
<15
|
Age | < 44 | 45 ~ 54 | 55 ~ 64 | 65 ~ 74 | > 75 |
Score | 0 | 2 | 3 | 5 | 6 |
Chronic Health Points (CHP)
-
Assigned if the patient has a history of severe organ system insufficiency or is immunocompromised.
-
For non-operative or emergency post-operative patients, 5 points; and for elective post-operative patients, 2 points.
-
Organ insufficiency or an immunocompromised state must have been evident before hospital admission and must conform to the following criteria:
Liver: biopsy proven cirrhosis and documented portal hypertension, episodes of past upper gastrointestinal bleeding attributed to portal hypertension, or prior episodes of hepatic failure/encephalopathy/coma.
Cardiovascular: New York Heart Association Class IV (i.e. symptoms of angina or cardiac insufficiency at rest or during minimal exertion).
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 suppress 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.
直接可以計算APACHE II的網頁
http://www.sfar.org/scores2/apache22.html
全站熱搜