APACHE II scoring system
| Acute physiology score | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| High normal range | Low normal range | |||||||||
| Variable | +4 | +3 | +2 | +1 | 0 | +1 | +2 | +3 | +4 | |
| Temperature (°C) | >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 (mm Hg) | >160 | 130–159 | 110–129 | 70–109 | 50–69 | <49 | ||||
| Heart rate (ventricular; beats/min) | >180 | 140–179 | 110–139 | 70–109 | 55–69 | 40–54 | <39 | |||
| Respiratory rate | >50 | 35–49 | 25–34 | 12–24 | 10–11 | 6–9 | <5 | |||
| Oxygenation (mm Hg) | ||||||||||
| AaDO2 when FiO2>0.5 | >500 | 350–499 | 200–349 | <200 | ||||||
| PaO2when FiO2 <0.5 | PO2>70 | PO2 61–70 | PO255–60 | PO2 <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 Na (mmol/l) | >180 | 160–179 | 155–159 | 150–154 | 130–149 | 120–129 | 11–119 | <110 | ||
| Serum K (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/100 ml) Double score for ARF | >3.5 | 2–3.4 | 1.5–1.9 | 0.6–1.4 | <0.6 | |||||
| Packed cell volume (%) | >60 | 50–59.9 | 46–49.9 | 30–45.9 | 20–29.9 | <20 | ||||
| While blood cell count (×103/mm3) | >40 | 20–39.9 | 15–19.9 | 3–14.9 | 1–2.9 | <1 | ||||
| Glasgow coma scale2-150 | ||||||||||
↵2-150 Score = 15 − actual Glasgow coma scale.
The APACHE II score is given by the sum of the acute physiology score, the age (in years) points, and the chronic health points. Age points are assigned as follows: 0, <44; 2, 45–54; 3, 55–64; 5, 65–74; and 6, >75. Chronic health points are assigned if the patient has a history of severe organ system insufficiency or is immunocompromised, as follows: 5, non-operative or emergency postoperative patients; 2, elective postoperative patients. Organ insufficiency or an immunocompromised state must have been evident before admission to hospital and must conform to the following criteria:liver, biopsy confirmed 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 (that is, symptoms of angina or cardiac insufficiency at rest or during minimal exertion);respiratory, chronic restrictive, obstructive, or vascular disease resulting in severe exercise restriction—that is, unable to climb stairs or perform household duties, or documented chronic hypoxia, hypercapnia, secondary polycythaemia, severe pulmonary hypertension (>40 mm Hg), or respirator dependency;renal, receiving chronic dialysis; andimmunocompromised, the patient has received treatment that suppresses resistance to infection—for example, immunosuppression, chemotherapy, radiotherapy, long term, high dose steroids, or has a disease that is sufficiently advanced to suppress resistance to infection, such as leukaemia, lymphoma, AIDS. AaDO2, alveolar–arterial oxygen difference; PaO2, arterial partial pressure of oxygen; FiO2, fraction of inspired oxygen; ARF, acute renal failure.