Acute physiology and chronic health evaluation pdf
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- Predicting outcome in critical care: the current status of the APACHE prognostic scoring system
- Is the Acute Physiology and Chronic Health Evaluation (APACHE) Scale Agist?
Predicting outcome in critical care: the current status of the APACHE prognostic scoring system
APACHE scores are probably the most widely used in Intensive care , to quantify the severity of the illness of the patients. They represent a usefull tool to compare populations of patients, in clinical studies, or in quality audit. Also provides an estimation of the length of stay. From APACHE II to APACHE IV, the scoring system has been complexified, taking into account a greater number of variable and extracting scores from several variable in a slightly different way , and making reference to a large database of coefficient individualized for an increased number of disease, for the calculation of the risk of death and length of stay. Only the disease-specific coefficients have been updated. The worst value obtained during the first 24h must be used.
Scoring systems estimate the prognosis and help in clinical decision making thus enhance the quality of care in Intensive care units. Methods: A descriptive study including patients admitted to medical intensive care unit was performed from January March in Southern Kerala. SPSS 20 was applied for statistical analysis, and clinical parameters were investigated with descriptive statistics. Healthcare professionals should therefore incorporate the disease severity measuring tools in their clinical practice to prioritize and optimize the care rendered in critical care units. Hospital mortality of adults admitted to intensive care units in hospitals with and without intermediate care units. Critical Care. Post ICU mortality in critically ill infected patients; an international study.
To use these scoring tools, their predicting power must be initially validated for the target patients. This study was conducted to evaluate the performance of these two scoring systems in an ICU for respiratory diseases in Iran. Information gathering was performed using a questionnaire. A total of records were used. The mean age of patients was Although new advances in the treatment and better settlement of severely ill patients in the intensive care unit ICU have resulted in their survival, such measures prolong their ICU stay and increase hospital expenses. Patients being informed of the severity of illness at the time of ICU admission helps decide continuation of expensive treatment and avoids unnecessary procedures.
Is the Acute Physiology and Chronic Health Evaluation (APACHE) Scale Agist?
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. It has not been validated for use in children or young people aged under 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 ie liver cirrhosis, portal hypertension, NYHA class IV heart failure, severe respiratory disease, dialysis dependent or is immunocompromised ie due to chemotherapy, radiation, high dose steroid therapy, or advanced leukemia, lymphoma or AIDS assign points as follows:. The method 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.
We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January and December A total of patients were available for analysis.