UMEM Educational Pearls

Category: Cardiology

Title: APACHE-HF Scoring System

Posted: 1/12/2015 by Semhar Tewelde, MD (Updated: 2/5/2023)
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APACHE-HF Scoring System

The Acute Physiology and Chronic Health Evaluation (APACHE) scoring system was established in the 1980's to predict critically ill patient prognosis (APACHE II, III, and IV have been published in last two decades).

The APACHE II scoring system involves combining 3 separate scores (acute physiology score, chronic health score, and age), which can be cumbersome to apply & thus is not often utilized in the emergency department (modified APACHE II doesn't include chronic health score & is less taxing).

No unique scoring system for acute heart failure (AHF) has been analyzed until present; the APACHE-HF score includes 8 criteria: mean arterial pressure (MAP), pulse, sodium, potassium, hematocrit, creatinine, age, and glasgow coma score (GCS).

AHF in-hospital mortality data was analyzed and compared using APACHE II, modified APACHE II, and APACHE- HF scores and the predictive value of the APACHE-HF score was found to be optimal when compared to the others.

 

References

Hirotake O, Akihiro S, et al. New scoring system (APACHE-HF) for predicting adverse outcomes in patients with acute heart failure: Evaluation of the APACHE II and Modified APACHE II scoring systems. Journal of Cardiology. Volume 64, Issue 6, Pages 421-510 (December 2014)