Chronic scoring systems

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. 

AMS acute myocardial syndrome ANC absolute neutrophil count ANS autonomic nervous system APACHE Acute Physiologic and Chronic Health Evaluation ICU illness severity scoring system APAP acetaminophen [N-acetyl-p-aminof enol] aPTT activated partial thromboplastin time ARB angiotensin 11 receptor blocker ARDS adult respiratory distress syndrome... 

The Acute Physiology and Chronic Health Evaluation (APACHE II) system (K12) is another scoring system, which was validated in a number of prospective clinical studies on acute pancreatitis (D6, K10, M7, 03, W8). A score of at least... 

Preventing CIN is of particular importance in patients with diabetes and chronic kidney disease, as these are two of the most powerful independent risk factors for CIN (77), Diabetics are more susceptible to (CIN) than are the nondiabetics, and diabetics with pre-existing chronic kidney disease (CKD) are at even greater risk (78). In a recently proposed CIN risk-scoring system, patient characteristics such as diabetes, age >75, chronic congestive heart failure, admission with acute pulmonary edema, hypotension, anemia and chronic kidney disease and various procedure-related characteristics including increasing volumes of contrast media, and intra-aortic balloon pump use were all found to reliably contribute to increased risk (79). 

The neonatal abstinence syndrome occurs in 30-80% of infants whose mothers have taken opiates during pregnancy. The incidence is higher in those whose mothers have a history of opioid dependence and are taking methadone maintenance than in those who are taking methadone for chronic pain (39). The methadone blood concentration may be a useful predictor of the likelihood of severe withdrawal requiring treatment, but clinical assessment by a standardized scoring system is still required to determine the need to treat the neonatal abstinence syndrome (40). 

Scoring systems have been proposed for classifying the results of grading and staging. (1,3,7,12,17,20-23,26) Such semiquantitative systems seem more practicable for scientific studies than for daily practice, (l) There is one particular system which can be recommended for histological scoring with regard to chronic hepatitis it represents a modification of proposals, (s. tabs. 34.2, 34.3)... 

Knodell, R.G., Ishak, K.G., Black, W.C., Chen, T.S., Craig, R., Kaplo-witz, N., Kiernan, T.W., Wollman, X Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981 1 431 -435... 

Rozario, R., Ramakrishna, B. Histopathological study of chronic hepatitis B and C a comparison of two scoring systems. X Hepatol. 2003 38 223-229... 

Mattsson L, Weiland O, Glaumann H. Application of a numerical scoring system for assessment of histological outcome in patients with chronic posttransfusion non-A, non-B hepatitis with or without antibodies to hepatitis C. Liver 1990 10 257-63. 

Myocardial damage and viability may be approximately quantified in the chronic phase of a Q-wave infarction. Different scores have been described, to know with a greater or lesser accuracy the amount of myocardium involved and, indirectly, the LV function (EF) (Palmeri et al., 1982). Selvester, Wagner and Hindman (1985) described a 31-point scoring system, on the basis of 50 criteria (presence of Q wave in different leads, R wave in V1-V2 as mirror pattern, etc.). This score quantifies the amount of infarcted tissue (3% of the left-ventricular mass for each point). Also, the reduction of the EF due to the infarction may be... 

Patients should be categorized into either prognostically mild or severe disease using any one of a number of validated multiple-factor scoring systems (Table 39 ). " Two widely used measures include Ranson s criteria and the Acute Physiology and Chronic Health Evaluation (APACHE II). The APACHE II (>8 points) system is more sensitive and specific than Ranson s criteria (>3 criteria), but it is also more complex. The APACHE II system uses 14 indicators of physiological and biochemical function that can be readily calculated upon admission to an intensive care unit. Ranson s criteria includes 11 variables that must be monitored at the time of admission and during the initial 48 hours of hospitalization. Patients with fewer than three Ranson criteria have a mortality rate of less than 1%, while... 

The outcome from intraabdominal infection is not determined solely by what transpires in the abdomen. Unsatisfactory outcomes in patients with intraabdominal infections may result from complications that arise in other organ systems. A complication commonly associated with mortality after intraabdominal infection is pneumonia.26 A high APACHE (Acute Physiology And Chronic Health Evaluation) II score, a low serum albumin, and a high New York Heart Association cardiac function status were significantly and independently associated with increased mortality from intraabdominal infection.27... 

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. 

In Tables 14.9 and 14.10, the last column reports the environmental impact points (EIPs) for typical applications of organic and conventional pesticides derived from the Pesticide Environmental Assessment System, or PEAS. This model produces relative rankings of risks based on defined use rates and use patterns (the formulation used to apply a pesticide, timing, target of the application, spray equipment used, etc). PEAS scores reflect an equal balancing of acute pesticide risks to farm workers, chronic risks via dietary exposure and exposures to birds, Daphnia and bees. 

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