Wed24November0743AM 9

Are the following true or false with regards to the APACHE II scoring system?

True / False

Systolic blood pressure and heart rate are cardiovascular measurements which are included in the physiological assessment Incorrect answer selected

Involves the assessment of 34 physiological measurements Correct

Is a widely used method of evaluating the condition of a neonate Correct

Points are awarded as the age increases above 45-years of age Correct

The Glasgow coma score is added to the physiology score Incorrect answer selected

Explanation

The APACHE scoring system (Acute Physiology And Chronic Health Evaluation) is used on ICU to assess the severity of illness in individual patients, and allows stratification of patient groups in order to compare different therapies.

APACHE scores may be weighted according to illness to give a mortality prediction for a specific patient. The APGAR scoring system is used to evaluate the condition of newly born neonates.

In 1981 the APACHE I system was introduced, and then in 1985 this was replaced by the APACHE II system. The APACHE II score is the sum of the acute physiology score (APS), the numerical assessment of chronic health and the points allocated for increasing age.

The acute physiology score assesses 11 physiological variables, with each being awarded points from 0 to 4 depending on their deviation from the normal range. The greater the deviation the greater number of points allocated.

The sum of these 11 variables is then added to a numerical assessment of neurological function (15 minus the Glasgow coma score), which is the 12th variable, to make up the APS. Therefore, the APACHE II score assesses 12 physiological variables (the APACHE I assesses 34).

Points are assigned to age in the following manner:

Less than 44 years - 0 points

45-54 years - 2 points

55-64 - 3 points

65-74 - 5 points and

More than 75 years - 6 points.

Note that points are allocated at the age of 45 years or above (not 50 years).

Chronic health points are awarded for organ insufficiency (cardiovascular, respiratory, renal and hepatic) or immunosuppression (pharmacological, radiation and disease states, for example, lymphoma, AIDS) which were documented prior to the present hospital admission.

The points assigned are greater for non-operative or emergency postoperative patients than for elective postoperative patients.

The mean arterial pressure (not systolic) and heart rate are the cardiovascular measurements included in the physiological assessment of the APS.

Answer Statistics

Not enough data to display the statistics

Average score: 50.00%

Times answered: 250