Acute Physiology, Age, and Chronic Health

Patients at greatest risk for mortality from acute pancreatitis are those who have multi-organ failure (e.g., hypotension, respiratory failure, or renal failure), pancreatic necrosis, obesity, volume depletion, greater than 70 years of age, and an elevated APACHE II score.3,4 The Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II score is a rating scale of disease severity in critically ill patients. 

APACHE Acute Physiology, Age, and Chronic Health Evaluation ARDS acute respiratory distress syndrome... 

Activated protein C in patients with severe sepsis and high risk of death (Acute Physiology, Age, and Chronic Health Evaluation II [APACHE II] score greater than 25). 

Nervous system The impact of tranexamic acid on seizures after cardiac surgery was evaluated [67. Tranexamic acid has proconvulsant properties that may be associated with postoperative seizures. A retrospective analysis of 5958 consecutive cardiac surgery patients identified several factors significantly associated with an increas risk of postoperative seizures tranexamic acid exposure, preoperative cardiac arrest, preoperative neurological disease, open chamber surgery, cardiopulmonary bypass time >150 min., previous cardiac surgery and an Acute Physiology, Age, and Chronic Health Evaluation II (APACHE) score >20. Thus, tranexamic acid use may present a readily modifiable risk factor for postoperative seizures. 

APACHE II Acute Physiology and Chronic Health Evaluation II a severity of disease classification system using a point score based on initial values of 12 routine physiologic measurements, age, and previous health status used to provide a general measure of disease severity. 

There are various severity of illness scoring systems for sepsis and trauma (R11). Severity scoring can be used, in conjunction with other risk factors, to anticipate and evaluate outcomes, such as hospital mortality rate. The most widely used system is the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) classification system (K12). The APACHE III was developed to more accurately predict hospital mortality for critically ill hospitalized adults (K13). It provides objective probability estimates for critically ill hospitalized patients treated in intensive care units (ICUs). For critically ill posttrauma patients with sepsis or SIRS, another system for physiologic quantitative classification and severity stratification of the host defense response was described recently (R11). However, this Physiologic State Severity Classification (PSSC) has yet not been applied routinely in ICU setting. 

In critically ill patients with AKI, urinary KIM-1 along with N-acetyl-[beta]-(D)-glucosaminidase activity (NAG) showed increasing trends with increasing severity of illness as assessed by Acute Physiology, Age, Chronic Health Evaluation (APACHE) II and multiple organ failure scores and could be correlated to the odds for both renal replacement therapy and hospital death, suggesting these biomarkers have some predictive ability for clinical outcomes in patients with AKI [308]. 

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