APACHE- ICU scoring system( SIMPLIFIED)

Summary

This video provides an in-depth look at ICU scoring systems, focusing on the Apache score. It explains various scoring methods used to predict patient mortality based on physiological and chronic health factors. The Apache score, developed in 1981, ranges from 0 to 71 and is applied within 24 hours of ICU admission. The video also covers the evolution of the Apache score, from Apache 1 and 2 to the refined Apache 3 and the latest Apache 4 model. It highlights how these scoring systems guide treatment decisions and predict disease severity, with Apache 2 remaining the most widely used despite newer versions.

Takeaways

• 😀 ICU scoring systems predict mortality based on underlying diseases.
• 😀 Scoring systems like Apache, SAPS, MPM, SOFA, and GCS help assess patient prognosis.
• 😀 Apache score, developed in 1981, was initially known as Apache 1 and later modified to Apache 2 in 1985.
• 😀 The Apache score is applied within the first 24 hours of a patient's ICU admission.
• 😀 Apache score ranges from 0 to 71, with higher scores indicating more severe disease and a higher risk of death.
• 😀 Apache score is not validated for children or individuals under 16 years of age.
• 😀 The Apache 2 score is calculated using acute physiological variables, age, and chronic health points.
• 😀 The acute physiological score includes 12 variables such as heart rate, oxygenation, and pH, measured within 24 hours of ICU admission.
• 😀 Chronic health points are assigned to patients with severe organ failure or those with significant immunocompromised states.
• 😀 Apache score helps predict mortality based on a patient's condition and measures disease severity in the ICU setting.
• 😀 Apache 3 (1991) and Apache 4 (2006) are refined versions of the Apache score, with Apache 4 currently recommended for use in U.S. ICUs.

Q & A

What is the purpose of scoring systems in the ICU?

Scoring systems in the ICU are developed to predict patient mortality due to underlying diseases. These systems help assess the severity of the patient's condition and the likelihood of survival.

What is the Apache score, and when is it applied?

The Apache score, or Acute Physiology and Chronic Health Evaluation score, is used to assess the severity of disease in ICU patients. It is calculated within 24 hours of a patient's admission to the ICU.

What are the two primary components of the Apache score?

The Apache score consists of two main components: the acute physiological score, which includes 12 variables, and the chronic health points, which account for a patient's underlying health conditions.

What physiological variables are included in the acute physiological score of Apache 2?

The acute physiological score includes variables such as rectal temperature, mean arterial pressure, heart rate, respiratory rate, oxygenation, arterial pH, bicarbonate, potassium, sodium, serum creatine, hematocrit, and total leukocyte count.

How are chronic health points calculated in the Apache score?

Chronic health points are assigned based on a patient's history of severe organ insufficiency or immunocompromised states. Patients with conditions such as liver failure, heart failure, or severe respiratory diseases are given additional points.

How do you calculate the Apache score for a patient?

The Apache score is calculated by assessing 12 physiological variables and chronic health points. For each variable, a score is assigned based on the patient's condition, and the total score is calculated by summing the individual scores.

Can the Apache score be used for patients under the age of 16?

No, the Apache score has not been validated for use in children or young people under the age of 16.

What is the range of the Apache score, and what does it indicate?

The Apache score ranges from 0 to 71. A higher score indicates more severe disease and a higher risk of mortality, with scores above 34 associated with mortality rates around 85%.

What is the difference between the Apache 2 and Apache 3 scores?

The Apache 3 score, introduced in 1991, is a refined version that includes 20 physiological variables compared to the 12 in Apache 2. It also includes the primary reason for ICU admission. While Apache 3 has replaced Apache 2 in some places, Apache 2 is still widely used.

What is the latest version of the Apache score, and where is it recommended for use?

The latest version, Apache 4, was published in 2006. It is currently recommended for use in U.S. ICUs.