Intensive Care Scoring Systems

Most often, the second version of “Acute Physiologic Assessment and Chronic Health Evaluation Score” (APACHE II) is applied, which was introduced to the clinic 1985th Here is a scoring is done so based on 12 physiological parameters, the age and the overall health on a scale from 0 to 71 is formed (see Fig. The APACHE II scoring system *). The APACHE III system was developed in the 1991st This scoring system is more complex, has 17 physiological parameters and is less common something. There are not many other systems u. a. the second version of the “SAPS II” (SAPS II), the “Mortality Prediction Model” (MPM) and the “Sequential Organ Failure Assessment” (SOFA) scores.

There have been developed to determine the severity of a disease in ICU patients different scoring systems. For predicting individual survival, these systems are only moderately accurate. they are more valuable for evaluating the quality of care and to conduct studies because they allow between groups of ICU patients with similarly severe disease comparisons in terms of their outcomes. Most often, the second version of “Acute Physiologic Assessment and Chronic Health Evaluation Score” (APACHE II) is applied, which was introduced to the clinic 1985th Here is a scoring is done so based on 12 physiological parameters, the age and the overall health on a scale from 0 to 71 is formed (see Fig. The APACHE II scoring system *). The APACHE III system was developed in the 1991st This scoring system is more complex, has 17 physiological parameters and is less common something. There are not many other systems u. a. the second version of the “SAPS II” (SAPS II), the “Mortality Prediction Model” (MPM) and the “Sequential Organ Failure Assessment” (SOFA) scores. Clinical Calculator: Mean vessel pressure (systemic or pulmonary) Clinical Calculator: APACHE II scoring system Clinical Calculator: Glasgow Coma Scale The APACHE II scoring system * Physiological parameters † points +4 +3 +2 +1 0 + 1 +2 +3 1 +4 core body temperature (° C) ? 41 ° C from 39 to 40.9 ° C – 38.5 to 38.9 ° C from 36 to 38.4 ° C from 34 to 35.9 ° C from 32 to 33.9 ° C 30 to 31.9 ° C ? 29.9 ° C 2 Arterial pressure (mmHg) ? 160130-159 110-129 – 70-109 – 50-69 – ? 49 3 heart rate ? 180140-179 110-139 – 70-109 – 55-69 40-54 ? 39 4 Respiratory Rate (ventilated or non-ventilated) ? 50 35-49 – 25-34 12-24 10-11 6-9 – ? 5 5 oxygenation: a) Fio2? 0.5: according to A-ADO2 ? 500350-499 200-349 – <200 - - - - b) FiO2 < 0.5: after PaO2 (mmHg) - - - -> 70 61-70 – 55-60 <55 6 Arterial pH ? 7.7 7.6 to 7.69 - 7.5 to 7.59 7.33 to 7.49 - 7.25 to 7, 32 7.15-7.24 <7.15 7 serum sodium (mmol / l) ? 180160-179 155-159 150-154 130-149 - 120-129 111-119 110 ? 8 serum potassium (mmol / l) ? 7 6-6.9 - 3.5-5 5.5-5.9 4 3 to 3.4 2.5 to 2.9 - <2.5 9 serum creatinine (mg / dl), double points in acute renal failure ? 3.5 2 to 3.4 1.5-1.9 - 0.6-1.4 - <0.6 - - 10 hematocrit (% ) ? 60 - 50 to 59.9 46 to 49.9 30 to 45.9 - 20 to 29.9 - <20 11 leukocytes (x 1000) ? 40 - 20 to 39.9 15 to 19.9 from 3 to 14.9 - from 1 to 2.9 - <1 12 Glasgow Coma Score (GCS) score = 15 minus measured point value of Glasgow -Koma scores (see Table: Glasgow Coma Scale *) the Acute Physiology Score results from the sum is VERSCHI 12 edenen individual scores. Age spots: There will be awarded 0 points for age <44 years, 2 points for 45-54 years, 3 points 55-64, 5 points for 65 to 74 years and 6 points for ? 75 years. For this, the scores for general health are counted: 2 points in elective postoperative patients with immunodeficiency or severe organ failure in history, 5 points in the patient without surgery or in postoperative patients after emergency surgery with immunodeficiency or severe organ failure ‡ (13) §. serum-HCO3 (venous in mmol / l) ? 52 41 to 51.9 - from 32 to 40.9 22 to 31.9 - from 18 to 21.9 15 to 17.9 <15 * APACHE II point scale = points from Acute Physiology Score + age points + points for overall health status. Minimum score = 0; maximum score = 71. An increase in the total number of points corresponds to the increase in mortality probability. † the worst value within the last 24 hours is chosen. ‡ General Health Status: Organ insufficiency (. Eg hepatic, cardiovascular, renal, pulmonary) or immune deficiency that has been known before the current hospitalization. § Optional parameter; only if there are no current blood gas analysis exists. A-a DO2 = alveolar-arterial oxygen gradient artery; FiO 2 = inspiratory O2 fraction. Adapted from Knaus WA, Draper EA, Wagner DP, JE Zimmerman: APACHE II: A severity of disease classification system Critical Care Medicine13. 818-829 1985.

Health Life Media Team

Leave a Reply