The presence of major organ failures is associated with increased patient mortality. Adjustment of the APACHE II score to reflect the number and duration of major organ failures can allow more accurate prediction of patient mortality in the ICU.
Organ System
Criteria for Failure
cardiovascular
heart rate <= 54 beats per minute
mean arterial blood pressure <= 49 mm Hg
occurrence of ventricular tachycardia and/or ventricular fibrillation
serum pH <= 7.24 with PaCO2 <= 49 mm Hg
respiratory
respiratory rate <= 5 per minute, or >= 49 per minute
PaCO2 > 50 mm Hg
AaDO2 > 350 mm Hg
dependent on ventilator on 4th day of organ system failure (do not apply for first 72 hours of organ system failure)
renal
(urine output <= 479 mL per day, OR <= 159 mL during an 8 hour period) AND serum urea >= 214 mg/dL
(urine output <= 479 mL per day, OR <= 159 mL during an 8 hour period) AND serum creatinine >= 3.5 mg/dL
hematological
WBC count <= 1000 per µL
platelet count <= 20000 per µL
hematocrit <= 20% AND not chronic renal failure
neurological
Glasgow coma score <= 6, in absence of sedation, at any one point in day
liver
clinical acute liver failure and P < 0.66 (see below)
