APACHE II (" Acute Physiology and Chronic Health Evaluation II ") is a severity-of-disease classification system, one of several ICU scoring systems . It is applied within 24 hours of admission of a patient to an intensive care unit (ICU): an integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death. The first APACHE model was presented by Knaus et al. in 1981.
7-415: APACHE II was designed to measure the severity of disease for adult patients admitted to intensive care units. It has not been validated for use in children or young people aged under 16. This scoring system is used in many ways which include: Even though newer scoring systems, such as APACHE III, have replaced APACHE II in many places, APACHE II continues to be used extensively because so much documentation
14-472: A simple way of classifying the extent of heart failure . It places patients in one of four categories based on how much they are limited during physical activity; the limitations/symptoms are in regard to normal breathing and varying degrees in shortness of breath and/or angina . It originated in 1928, when no measurements of cardiac function were possible, to provide a common language for physicians to communicate. Despite difficulties in applying it, such as
21-606: Is based on it. The point score is calculated from 12 admission physiologic variables comprising the Acute Physiology Score, the patient's age, and chronic health status: If the patient has a history of severe organ system insufficiency (i.e. liver cirrhosis, portal hypertension, NYHA class IV heart failure, severe respiratory disease, dialysis dependent) or is immunocompromised (i.e. due to chemotherapy, radiation, high dose steroid therapy, or advanced leukemia, lymphoma or AIDS) assign points as follows: The method
28-569: Is optimized for manual calculation, by using integer values and limiting the number of options so that data fits on a single-sheet paper form. The score is not recalculated during the stay. It is by definition an admission score. If a patient is discharged from the ICU and subsequently readmitted, a new APACHE II score is calculated. In the original research paper that described the APACHE II score, patient prognosis (specifically, predicted mortality)
35-479: The challenge of consistently classifying patients in class II or III, because functional capacity is such a powerful determinant of outcome, it remains arguably the most important prognostic marker in routine clinical use in heart failure today. With time the classification system evolved and updated multiple times. Presently, the ninth edition of the NYHA classification is being used in the clinical practice released in
42-566: The patient's arrival at the hospital and their ICU admission is recorded. To evaluate the severity of disease 20 physiologic variables are measured, compared to 12 variables for APACHE II. APACHE III scores range from 0 to 299. APACHE IV, published in 2006, is the latest version. The model was developed using data from 104 intensive care units (ICUs) in 45 U.S. hospitals and could be recommended to use in U.S. ICUs. New York Heart Association Functional Classification The New York Heart Association (NYHA) Functional Classification provides
49-412: Was computed based on the patient's APACHE II score in combination with the principal diagnosis at admission. A method to compute a refined score known as APACHE III was published in 1991. The score was validated on the dataset from 17,440 adult medical/surgical intensive care unit (ICU) admissions at 40 US hospitals. The prognostic system of APACHE III has two options: When possible, the time between
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