APACHE II Score Form

 

 

HIGH ABNORMAL RANGE

 

LOW ABNORMAL RANGE

 

PHYSIOLOGIC VARIABLE

+4

+3

+2

+1

0

+1

+2

+3

+4

1

Temperature rectal (oC)

>=41

39-40.9

 

38.5-38.9

36.0-38.4

34-35.9

32-33.9

30-31.9

<=29.9

2

Mean arterial pressure =

(2 x diastolic+systolic)/3

>=160

130-159

110-129

 

70-109

 

50-69

 

<=49

3

Heart rate (venticular response)

>=180

140-179

110-139

 

70-109

 

55-69

40-54

<=39

4

Respiratory rate (non-ventilated or ventilated)

>=50

35-49

 

25-34

12-24

10-11

6-9

 

<5

5

Oxygenation

A-aDO2 or PaO2(mmHg)

a)FiO2>0.5:record A-aDO2

>=500

350-499

200-349

 

<200

 

 

 

 

 

b)FiO2<0.5:record only PaO2

 

 

 

 

>70

61-70

 

55-60

<55

6

Arterial pH If no ABGs record Serum HCO3 below

>=7.7

7.6-7.69

 

7.5-7.59

7.33-7.49

 

7.25-7.32

7.15-7.24

<7.15

7

Serum Sodium

>=180

160-179

155-159

150-154

130-139

 

120-129

111-119

<=110

8

Serum Potassium

>=7

6-6.9

 

5.6-5.9

3.5-5.4

3-3.4

2.5-2.9

 

<2.5

9

Serum Creatinin (mg/dl)

Double Point for acute renal failure

>=3.5

2-3.4

1.5-1.9

 

0.6-1.4

 

<0.6

 

 

10

Hematocrit (%)

>=60

 

50-59.9

46-49.9

30-45.9

 

20-29.9

 

<20

11

White Blood Count

>=40

 

20-39.9

15-19.9

3-14.9

 

1-2.9

 

<1

12

Glasgow Coma Scale

(Score = 15 minus actual GCS)

15-GCS=

 

 

 

 

 

 

 

 

A

Total Acute Physiology Score (APS)

Sum of the 12  individual variable points =

*

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

 

Glasgow Coma Scale

(Circle appropriate response)

B     Age

Points

C

Chronic Healts Points

Apache-II Score (sum of A+B+C)

Eyes open

4 - spontaneously

3 - to verbal

2 - to painful stimul

1 - no response

 

Motor response

6 - to verbal command

5 - localizes to pain

4 - withdraws to pain

3 - decorticate

2 - decerebrate

1 - no response

verbal - nonintubated

5 - oriented and controversed

4 - disoriented and talks

3 - inaproppriate words

2 - incomprehensible sounds

1 - no response

 

verbal - intubated

5 - seems able to talk

3 - questionable ability to talk

1 - generally unresponsable

Age

<44

45-54

55-64

65-74

>75

 

Age points =

Points

0

2

3

5

6

 

 

 

 

 

 

Liver

Cardiovascular

Pulmonary

 

Kidney

Immune

 

If any of the 5 CHE categories is answered with yes give +5 points for non-operative or emergency postoperative patients

- Cirrhosis with PHT or encephalopathy

- class IV angina or at rest or with minimal self care activities

- chronic hypoxemia or hypercapnia or polycytaemia of PHT > 40mmHg

- chronic peritoneal or hemodyalys

- immune compromised host

Chronic Health Points =

   A APS points

+ B Age points

+ C Chronic Health Points

__________

= Total Apache-II

 

Credit given to Nick Mendel, Kiev, Ukraine, for producing this document.