APACHE II Score
Acute Physiology and Chronic Health Evaluation II - A severity of disease classification system. Predicts hospital mortality.
Interpretation & Management
Evaluation is based on the worst physiological variables recorded during the first 24 hours of ICU admission.
What is the APACHE II Score?
The APACHE II (Acute Physiology and Chronic Health Evaluation II) score is a globally recognized clinical scoring system in intensive care. It quantifies the severity of disease in ICU patients based on 12 acute physiological variables, age, and chronic health status.
Clinical Utility and Prognosis
Calculated ideally within the first 24 hours of admission, the APACHE II score provides a numerical value (0 to 71). A higher score correlates with a worse prognosis and higher hospital mortality. It is essential for risk stratification and quality assessment in intensive care.
Evolution to APACHE III and APACHE IV
Although newer models have been developed, such as APACHE III (1991) and APACHE IV (2006), which incorporate a larger number of clinical variables and updated disease-specific mortality equations, APACHE II remains highly relevant. The computational complexity of the newer versions often requires integrated software, which explains why the relative simplicity and robustness of APACHE II keep it a standard reference at the bedside.
Critical Actions & Management
APACHE II is a severity classification system.
- It is not intended to predict an individual patient's outcome.
- Used to compare outcomes between groups.
Estimated Hospital Mortality
| APACHE II Score | Mortality |
|---|---|
| 0 - 4 | ~ 4.0 % |
| 5 - 9 | ~ 8.0 % |
| 10 - 14 | ~ 15.0 % |
| 15 - 19 | ~ 25.0 % |
| 20 - 24 | ~ 40.0 % |
| 25 - 29 | ~ 55.0 % |
| 30 - 34 | ~ 73.0 % |
| ≥ 35 | > 85.0 % |
References:
1. Knaus WA, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985.
[PubMed]
2. Naved SA, et al. Validity of APACHE II score in predicting mortality. Indian J Crit Care Med. 2011.
[PMC - NIH]
-
💡 Committed to scientific accuracy, if you notice any clinical or technical discrepancy, please let us know.