Abstract
Medical care has evolved over the decades. Intensive care unit (ICU) care is the backbone for the improvement in the outcome parameters of patients across all specialties of medicine and surgery. Scoring systems are one of the widely used tools in medical practice to diagnose, stage, treat, and prognosticate patients. They help in deciding the nature and degree of intervention that is best for the patient. The acceptance of newer methods and technologies into the ICU is based on the results of statistically sound clinical studies. Many of these clinical studies will not be possible without the use of these scoring systems for sample selection and also to evaluate outcomes. So, the scoring systems are part and parcel of the ICU setup, and they have become inevitable in the present-day medical care.
Acute Physiological and Chronic Health Evaluation Index II (APACHE II) score is one of the widely used scoring systems in ICUs across the world. It has evolved from the APACHE I score and further modified into APACHE III and APACHE IV. One must be aware of the various pitfalls while calculating the APACHE II score and it uses. Apart from the APACHE II score, other scoring systems like Simplified Acute Physiological Score, Mortality Prediction Model, Pediatric Index of Mortality, Sequential Organ Failure Assessment score, etc. are used. In the setting of trauma, several scoring systems are used such as Revised Trauma Score (RTS), Injury Severity Score (ISS), Trauma Revised Injury Severity Score (TRISS), Penetrating Abdominal Trauma Index (PATI), etc. One must also be aware of how to choose a scoring system. Use of preprinted charts and online calculators in smart phones will make the calculation process easy. One must be wise enough to interpret the data from scoring systems to make clinical decisions as no scoring system is 100 percent perfect.
Keywords
- Scoring systems
- APACHE II score
- SAPS II
- APACHE III
- APACHE IV
- ICU scores
- Mortality prediction
- Mortality Prediction Model
- Pediatric Index of Mortality
- SOFA
- Modified Marshall Score
- Audit and research
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Abbreviations
- APACHE:
-
Acute Physiological and Chronic Health Evaluation Index
- AUROC:
-
Area under the ROC curve
- GCS:
-
Glasgow Coma Score
- ICU:
-
Intensive care unit
- ISS:
-
Injury Severity Score
- MPM:
-
Mortality Prediction Model
- PATI:
-
Penetrating Abdominal Trauma Index
- PIM:
-
Pediatric Index of Mortality
- ROC:
-
Receiver operating characteristic
- RTS:
-
Revised Trauma Score
- SAPS:
-
Simplified Acute Physiological Score
- SIRS:
-
Systemic Inflammatory Response Syndrome
- SMR:
-
Standardized morality ratio
- SOFA:
-
Sepsis-related Organ Failure Assessment
- TRISS:
-
Trauma Revised Injury Severity Score
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Yelamanchi, R. (2022). The APACHE II Scoring Systems and the ICU. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Biomarkers in Trauma, Injury and Critical Care. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Cham. https://doi.org/10.1007/978-3-030-87302-8_52-1
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DOI: https://doi.org/10.1007/978-3-030-87302-8_52-1
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