Once the APACHE III points are tabulated, the risk equation can be calculated and the risk of hospital mortality estimated.
Data Requirements:
(1) beta value for admission status to ICU
(1a) if nonoperative patient, select location prior to admission to ICU
(1b) if operative patient, select emergency or non-emergency surgery
(2) beta value for major disease category
(2a) if nonoperative patient, the major nonoperative disorder at admission to ICU
(2b) if operative patient, the major nonoperative disorder at admission to ICU
(3) total APACHE III points
total APACHE III points =
= (age subscore) + (chronic health subscore) + (physiologic subscore) + (acid-base subscore) + (neurologic subscore)
where:
• minimum total APACHE III score = 0
• maximum total APACHE III score = 299 (24 + 23 + 192 + 12 + 48)
APACHE III risk equation =
= (beta value for admission status) + (beta value for major disease category) + (0.0537 * (total APACHE III points))
risk of hospital mortality =
= (EXP(APACHE III risk equation)) / ((EXP(APACHE III risk equation)) + 1)
NOTE: Since APACHE III is a proprietary system, the beta values for admission status and disease categories listed below are not published in the literature and are only available by subscribing to the commercial system.
Admission - Nonoperative
|
Location prior to Current ICU Admission |
beta |
|---|---|
|
emergency room |
|
|
hospital floor |
0.2744 |
|
transfer from another hospital |
|
|
other ICU |
|
|
readmission to same ICU |
|
|
operating or recovery room |
|
Admission - Operative
|
Surgery Prior to Current ICU Admission |
beta |
|
emergency surgery |
0.0752 |
|
nonemergency surgery |
|
Major Disease Categories - Nonoperative
|
Class |
Operation |
beta |
|---|---|---|
|
Cardiovascular or vascular |
cardiogenic shock |
|
|
|
cardiac arrest |
|
|
|
aortic aneurysm |
|
|
|
congestive heart failure |
|
|
|
peripheral vascular disease |
|
|
|
rhythm disturbance |
|
|
|
acute myocardial infarction |
|
|
|
hypertension |
|
|
|
other cardiovascular disease |
|
|
Respiratory |
parasitic pneumonia |
|
|
|
aspiration pneumonia |
-4.5575 |
|
|
respiratory neoplasm, including larynx and trachea |
|
|
|
respiratory arrest |
|
|
|
pulmonary edema, non-cardiogenic |
|
|
|
bacterial or viral pneumonia |
|
|
|
chronic obstructive pulmonary disease |
|
|
|
pulmonary embolism |
|
|
|
mechanical airway obstruction |
|
|
|
asthma |
|
|
|
other respiratory diseases |
|
|
Gastrointestinal |
hepatic failure |
|
|
|
GI perforation or obstruction |
|
|
|
GI bleeding due to varices |
|
|
|
GI inflammatory disease (ulcerative colitis, Crohn's, pancreatitis, etc) |
|
|
|
GI bleeding due to ulcer or laceration |
|
|
|
GI bleeding due to diverticulosis |
|
|
|
other GI disease |
|
|
Neurologic |
intracerebral hemorrhage |
|
|
|
subarachnoid hemorrhage |
|
|
|
stroke |
|
|
|
neurologic infection |
|
|
|
neurologic neoplasm |
|
|
|
neuromuscular disease |
|
|
|
seizure |
|
|
|
other neurologic disease |
|
|
Sepsis |
sepsis (other than urinary tract) |
|
|
|
sepsis of urinary tract origin |
|
|
Trauma |
head trauma with or without multiple trauma |
|
|
|
Multiple trauma without head trauma |
|
|
Metabolic |
metabolic coma |
|
|
|
diabetic ketoacidosis |
|
|
|
drug overdose |
|
|
|
other metabolic diseases |
|
|
Hematologic |
coagulopathy, neutropenia or thrombocytopenia |
|
|
|
other hematologic diseases |
|
|
Renal diseases |
|
|
|
Other medical diseases |
|
|
Major Disease Categories - Postoperative
|
Class |
Operation |
beta |
|---|---|---|
|
Vascular or Cardiovascular |
dissecting or ruptured aorta |
|
|
|
peripheral vascular disease (no bypass graft) |
|
|
|
valvular heart surgery |
|
|
|
elective abdominal aneurysm repair |
|
|
|
peripheral artery bypass graft |
|
|
|
carotid endarterectomy |
|
|
Respiratory |
respiratory infection |
|
|
|
lung neoplasm |
|
|
|
upper respiratory neoplasm (mouth, sinus, larynx, trachea) |
|
|
|
other respiratory disease |
|
|
Gastrointestinal |
GI perforation or rupture |
|
|
|
GI inflammatory disease |
|
|
|
GI obstruction |
-4.6974 |
|
|
GI bleeding |
|
|
|
liver transplant |
|
|
|
GI neoplasm |
|
|
|
GI cholecystitis or cholangitis |
|
|
|
other GI disease |
|
|
Neurologic |
intracerebral hemorrhage |
|
|
|
subdural or epidural hematoma |
|
|
|
subarachnoid hemorrhage |
|
|
|
laminectomy or other spinal cord surgery |
|
|
|
craniotomy for neoplasm |
|
|
|
other neurologic diseases |
|
|
Trauma |
head trauma (with or without multiple trauma) |
|
|
|
multiple trauma without head trauma |
|
|
Renal |
renal neoplasm |
|
|
|
other renal diseases |
|
|
Gynecologic |
hysterectomy |
|
|
Orthopedic |
hip or extremity fracture |
|
Specialty: Critical Care, Emergency Medicine
