APACHE II Scoring System and Mortality Estimates (Acute Physiology and Chronic Health Disease Classification System II)

 

Temperature (Degrees C)
	>= 41 (4 points) 39-40.9 (3 points) 38.5-38.9 (1 point) 36-38.4 (0 points) 34-35.9 (1 point) 32-33.9 (2 points) 30-31.9 (3 points) <= 29.9 (4 points) _______________________________
Mean Arterial Pressure (mmHg)
	>= 160 (4 points) 130-159 (3 points) 110-129 (2 points) 70-109 (0 points) 50-69 (2 points) <= 49 (4 points) _______________________________
Heart Rate
	>= 180 (4 points) 140-179 (3 points) 110-139 (2 points) 70-109 (0 points) 55-69 (2 points) 40-54 (3 points) <= 39 (4 points) _______________________________
Respiratory Rate
	>= 50 (4 points) 35-49 (3 points) 25-34 (1 point) 12-24 (0 points) 10-11 (1 point) 6-9 (2 points) <= 5 (4 points) _______________________________
A-aPO2(FiO2>50%) or PaO2(FiO2<50%)
	>= 500 (4 points) 350-499 (3 points) 200-349 (2 points) < 200 or PaO2 > 70 (0 points) PaO2 61-70 (1 point) PaO2 55-60 (3 points) PaO2 < 55 (4 points) _______________________________
Arterial pH or HCO3
	pH >=7.7 or HCO3 >=52 (4 points) pH 7.6-7.69 or HCO3 41-51.9 (3 points) pH 7.5-7.59 or HCO3 32-40.9 (1 point) pH 7.33-7.49 or HCO3 22-31.9 (0 points) pH 7.25-7.32 or HCO3 18-21.9 (2 points) pH 7.15-7.24 or HCO3 15-17.9 (3 points) pH <7.15 or HCO3 <15 (4 points) _______________________________
Serum Na+ (mEq/L)
	>= 180 (4 points) 160-179 (3 points) 155-159 (2 points) 150-154 (1 point) 130-149 (0 points) 120-129 (2 points) 111-119 (3 points) <= 110 (4 points) _______________________________
Serum K+ (mEq/L)
	>= 7 (4 points) 6-6.9 (3 points) 5.5-5.9 (1 point) 3.5-5.4 (0 points) 3-3.4 (1 point) 2.5-2.9 (2 points) < 2.5 (4 points) _______________________________
Serum Creatinine (ARF means Acute Renal Failure)
	>= 3.5 (4 points) > 3.5 in ARF (8 points) 2-3.4 (3 points) 2-3.4 in ARF (6 points) 1.5-1.9 (2 points) 1.5-1.9 in ARF (4 points) 0.6-1.4 (0 points) < 0.6 (2 points) _______________________________
Hematocrit
	>= 60 (4 points) 50-59.9 (2 points) 46-49.9 (1 point) 30-45.9 (0 points) 20-29.9 (2 points) < 20 (4 points) _______________________________
WBC Count(10^9/L)
	>= 40 (4 points) 20-39.9 (2 points) 15-19.9 (1 point) 3-14.9 (0 points) 1-2.9 (2 points) < 1 (4 points) _______________________________
Glasgow
	15 (0 points) 14 (1 point) 13 (2 points) 12 (3 points) 11 (4 points) 10 (5 points) 9 (6 points) 8 (7 points) 7 (8 points) 6 (9 points) 5 (10 points) 4 (11 points) <=3 (12 points) _______________________________
Age (years)
	>= 75 (6 points) 65-74 (5 points) 55-64 (3 points) 45-54 (2 points) <= 44 (0 points) _______________________________
Chronic Health Problems: 1) Cirrhosis of the liver confirmed by biopsy 2) New York Heart Association Class IV 3) Severe COPD -- Hypercapnia, home O2 use, or pulmonary hypertension 4) On regular dialysis or 5) Immunocompromised
		None (0 points)
		Non-Surgical (5 points)
		Emergent operation (5 points)
		Elective operation (2 points)

 

Total Criteria Point Count:
 

 

Apache II Score / Approximate Mortality

 

0 to 4 points:	4% non-op, 1% post-op
5 to 9 points:	8% non-op, 3% post-op
10 to 14 points:	15% non-op, 7% post-op
15 to 19 points:	24% non-op, 12% post-op
20 to 24 points:	40% non-op, 30% post-op
25 to 29 points:	55% non-op, 35% post-op
30 to 34 points:	Approx 73% both
35 to 100 points:	85% non-op, 88% post-op

 

 

References

1. Knaus WA, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985 Oct;13(10):818-29. PubMed ID: 3928249