OPUS 12 Foundation, Inc.

APACHE II CALCULATOR
Apache II APACHE II Calculator

APACHE II CALCULATOR

(Acute Physiology And Chronic Health Evaluation)

Temperature (°C)

Mean Arterial Pressure (mmHg)

Heart Rate

Respiratory Rate

If FIO2 >= 0,5 : (A-a) O2
(
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If FIO2 < 0,5 : PaO2

If no A.B.Gs :
Serum HCO3-(mmol/L)

Arterial pH

Serum Sodium (mmol/L)

Serum Potassium (mmol/L)

Serum Creatinine
With Acute Renal Failure

Serum Creatinine
Without Acute Renal Failure

Ht (%)

W.B.C (x103/ mm3 )

Glasgow Coma Score

Age

Apache II

Chronic Organ Insufficiency
(
Help) immuno-compromised

Predicted mortality

 

Logit = -3,517+( Apache II) * 0,146
Predicted mortality =eLogit/(1+eLogit)


Predicted mortality (Adjusted)


Logit = -3,517+( Apache II) * 0,146 + Diagnostic category weight
Predicted mortality =eLogit/(1+eLogit)
Diagnostic category weight (y)=
(a point for decimals)

Nonoperative

y

Postoperative patients

y

y (if emergency)

Respiratory failure or insufficiency from:

Multiple trauma

-1.684

-1.081
Asthma / allergy

-2.108

Admission due to chronic cardiovascular disease

-1.376

-0.773
COPD

-0.367

Peripheral vascular surgery

-1.315

-0.712
Pulmonary edema (noncardiogenic)

-0.251

Heart valve surgery

-1.261

-0.658
Postrespiratory arrest

-0.168

Craniotomy for neoplasm

-1.245

-0.642
Aspiration / poisoning / Toxic

-0.142

Renal surgery for neoplasm

-1.204

-0.601
Pulmonary embolus

-0.128

Renal Transplant

-1.042

-0.439
Infection

0

Head trauma

-0.955

-0.352
Neoplasm

0.891

Thoracic surgery for neoplasm

-0.802

-0.199

Cardiovascular failure or insufficiency from :

Craniotomy for ICH/ SDH/ SAH

-0.788

-0.185
Hypertension

-1.798

Laminectomy and other spinal cord surgery

-0.699

-0.096
Rythm disturbance

-1.368

Hemorrhagic shock

-0.682

-0.079
Congestive heart failure.

-0.424

GI Bleeding

-0.617

-0.014
Hemorrhagic shock / hypovolemia

0.493

GI surgery for neoplasm

-0.248

0.355
Coronary artery disease

-0.191

Respiratory insufficiency

-0.140

0.463
Sepsis

0.113

GI perforation / obstruction

0.060

0.663
Post cardiac arrest

0.393

If not in one of the above, wich major vital organ system led to ICU admission post surgery

Cardiogenic shock

-0.259

Neurologic

-1.150

-0.574
Dissecting thoracic / abdomina aneurysm

0.731

Cardiovascular

-0.797

-0.194

Trauma

Respiratory

-0.610

-0.007
Multiple trauma

- 1.228

Gastro-intestinal

-0.613

-0.01
Head injury

-0.517

Metabolic / renal

-0.196

0.407

Neurologic

Seizure disorder

-0.584

ICH/ SDH/ SAH

0.723

Other

Drug overdose

-3.353

Diabetic ketoacidosis

-1.507

GI Bleeding

0.334

If not in one of the groups above, wich major organ system was the principal reason for admission:

Metabolic / renal

-0.885

Respiratory

-0.890

Neurologic

-0.759

Cardiovascular

0.470

Gastrointestinal

0.501

Ref : Knaus WA et al. APACHE II : A severity of disease classification system. Crit Care Med. 1985;13:818-29.

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(A-a)O2 Gradient ( mmHg )

(A-a)O2 Gradient ( KPa )

PaCO2

(A-a)O2 Gradient

(A-a)O2 Gradient

PaCO2

PaO2

PaO2

FIO2 (a point for decimals)
(ex: 0.6)

FIO2 (a point for decimals)
(ex: 0.6)

Formula (simplified):

(A-a)O2 Gradient = (( PAtm - PH2O) * FIO2 - ( PaCO2 / Resp.Quot )) - PaO2

With R.Q =1 , PAtm =760, PH2O = 47

(A-a)O2 Gradient =(760-47)*FIO2 - PaCO2 - Pa02

Formula (simplified):

(A-a)O2 Gradient = (( PAtm - PH2O) * FIO2 - ( PaCO2 / Resp.Quot )) - PaO2

with RQ =1 , PAtm =100, PH2O = 6.2

(A-a)O2 Gradient =(100-6.2)*FIO2 - PaCO2 - Pa02

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Eyes Open

Verbal

Motor

Spontaneous
To speech
To pain
Absent

Converses / Oriented
Converses / Disoriented
Inappropriate
Incomprehensible
Absent

Obeys
Localizes pain
Withdraws (flexion)
Decorticate (flexion) rigidity
Decerebrate (extension) rigidity
Absent

Glasgow=

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Chronic Organ Insufficiency

Liver insufficiency

Cardiovascular

Respiratory

Renal

Immuno-depression

Biopsy proven cirrhosis
Documented portal hypertension,
Episodes of past upper GI bleeding attributed to portal hypertension
Prior episodes of hepatic failure / encephalopathy / coma.

NYHA Class IV

Chronic restrictive, obstructive or vascular disease resulting in severe exercice restriction, i.e. unable to climb stairs or perform household duties.
Documented chronic hypoxia, hypercapnia, secondary polycythemia , severe pulmonary hypertension (> 40 mmHg), or respirator dependency.

Receiving chronic dialysis

The patient has received therapy that suppresses resistance to infection e.g. immuno-suppression, chemotherapy, radiation, long term or recent hight dose steroids, or has a disease that is sufficiently advanced to suppress resistance to infection, e.g. leukemia, lymphoma, AIDS.

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