ICU mortality prediction
Total Score
Estimated mortality ~4-10%.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.
The Acute Physiology and Chronic Health Evaluation (APACHE) II is a widely used severity-of-disease classification system. Calculated within the first 24 hours of ICU admission, it integrates 12 physiological variables, age, and severe chronic health conditions to accurately estimate the probability of in-hospital mortality.
Always use the worst physiological values recorded during the initial 24 hours of ICU admission, not necessarily the admission values themselves. This captures the peak physiological derangement and ensures scoring accuracy.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-829.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Apply APACHE II within the first 24 hours of ICU admission to estimate in-hospital mortality and communicate disease severity. It is most valid for medical and surgical ICU patients; separate validation data exist for specific populations (trauma, post-cardiac surgery, burns). Use the worst value recorded in the first 24 hours for each physiological variable. Chronic health points differ between elective post-operative (2 pts) and emergency/non-operative patients (5 pts) — ensure correct categorization.
The GCS component contributes a maximum of 12 points to APACHE II (calculated as 15 − actual GCS). In sedated or pharmacologically paralysed patients, record the estimated pre-sedation GCS if the clinical team can reliably provide it; otherwise document the limitation. APACHE II scores have been used as inclusion criteria for clinical trials and to benchmark ICU performance against predicted mortality ratios — a standardized mortality ratio (SMR) > 1.2 may signal underperformance or case-mix differences.
APACHE II was derived in 1985 and may overestimate mortality in contemporary ICUs due to advances in critical care. It performs less well in immunocompromised, post-cardiac surgery, and hepatic failure patients — condition-specific scoring (e.g., SOFA for sepsis, Child-Pugh for cirrhosis) is preferred in those groups. Do not re-score during the ICU stay for prognostic purposes; APACHE II is a 24-hour admission tool, not a daily tracker. Serial organ function is better assessed with SOFA.