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APACHE II: a severity of disease classification system.

W A Knaus, E A Draper, D P Wagner

    Critical Care Medicine
    |October 1, 1985
    PubMed
    Summary
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    The APACHE II scoring system accurately predicts hospital death risk in intensive care units. This validated severity of disease classification aids in patient stratification and therapy comparison.

    Area of Science:

    • Critical Care Medicine
    • Health Services Research
    • Biostatistics

    Background:

    • Assessing disease severity is crucial for patient management and research in intensive care.
    • Existing methods may lack comprehensive or validated measures for predicting patient outcomes.
    • The need for a standardized, reliable scoring system to evaluate intensive care unit (ICU) performance and therapeutic interventions.

    Purpose of the Study:

    • To present the development and validation of the APACHE II (Acute Physiology and Chronic Health Evaluation II) scoring system.
    • To establish APACHE II as a general measure of disease severity.
    • To demonstrate its utility in stratifying risk and comparing therapeutic outcomes.

    Main Methods:

    • Utilized initial values from 12 routine physiologic measurements.

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  • Incorporated patient age and previous health status into the scoring algorithm.
  • Validated the system on 5815 intensive care admissions across 13 hospitals.

    • Main Results:

    • An increasing APACHE II score (0-71) strongly correlated with the risk of hospital death.
    • This correlation was observed across various common diseases.
    • The system demonstrated prognostic stratification capabilities for acutely ill patients.

    Conclusions:

    • APACHE II provides a validated, general measure of disease severity.
    • The scoring system can effectively stratify patients and aid in comparing therapeutic efficacy.
    • APACHE II is a valuable tool for evaluating ICU resource utilization and inter-hospital comparisons.