Approved by: Kim Hlobik
INSTRUCTIONS
To Calculate APS Score:
To determine disease category
Following the methodology precisely, determine the physiological variable furthest from the reference point, whether higher or lower/above or below. Assign APS points to that single, most deviant value.
Resources for the correct collection of data elements:
1. Knaus WA, Wagner DP, Draper EA, Zimmerman JE. The APACHE III prognostic system: risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100:1619-1636.
2.
http://train.apache-web.com/apacheIIIwebcourse/courselogin/login. cfm
The accuracy of APACHE predictions is dependent upon the quality of data upon which predictions are made. Deviations from the precise data collection methodology may result in errors in prediction which Cerner Corporation cannot be responsible for.
Using the disease mapping table, select the single primary reason for ICU admission. Patients coming to the ICU from the operating room or post-anesthesia care unit must be assigned surgical diagnoses. ALL OTHER PATIENTS will receive a non-operative diagnosis.
Diseases are categorized by body system, and then into operative and non-operative
Approved by: Kim Hlobik
Additional Notes
Determine the disease category associated with the ICU admitting diagnosis.
To calculate hospital mortality and/or ICU length of stay
First, select the appropriate worksheet for the prediction required and the patient (CABG, Non-CABG) type
Enter the required values or use 1=yes, blank=no.
For each set of variables, the options within each color block are mutually exclusive. Select only one of the options as a "yes" (1), the rest "no" (0) or blank. More than one selection from a single group will result in an error message. Example: If disease category is SCAROTID=1, all other disease categories=blank.
Error messages will appear in red if more than one mutually exclusive variable is selected. All cells except those that accept data for the calculations are "locked".
Step 1: Calculate Acute Physiology Score
Pulse (beats/min) <=39 8 Pulse points 0
Select heart rate furthest from 75 40-49 5
50-99 0 100-109 1 110-119 5 120-139 7 140-154 13 >=155 17
Mean Blood Pressure (MAP) <=39 23 MAP points 0
Select MAP furthest from 90 40-59 15
60-69 7 70-79 6 80-99 0 100-119 4 120-129 7 130-139 9 >=140 10
Temperature (degrees Centigrade) <=32.9 20 Temperature points 0
Select core temperature furthest from 38. 33-33.4 16
Add 1 degree Centigrade to axillary temps 33.5-33.9 13
prior to selecting worst value 34-34.9 8
35-35.9 2
36-39.9 0
>=40 4
Respiratory Rate (breaths/min)* <=5 17 Respiratory rate points
Select respiratory rate furthest from 19 6-11 8
*for patients who are ventilated 12-13 7
no points are given for respiratory 14-24 0
rates of 6-12. 25-34 6
35-39 9
40-49 11
>=50 18
PaO2 (mmHg)* <=49 15 PaO2 points
*Use only for non-intubated patients or 50-69 5
intubated patients with FiO2 <0.5 (50%). 70-79 2
>=80 0 OR
OR
A-aDO2* <100 0 A-aDO2 points
*Only use A-aDO2 for intubated patients 100-249 7
with FiO2 >=0.5 (50%). Do not use PaO2 250-349 9
weights for these patients. 350-499 11
>=500 14
Hematocrit (%) <=40.9 3 Hematocrit points
Select hematocrit furthest from 45.5. 41-49 0
>=50 3
WBC (cu/mm) <1.0 19 WBC points
Select WBC furthest from 11.5. 1.0-2.9 5
3.0-19.9 0
20-24.9 1
>=25 5
Creatinine without ARF* (mg/dl) <=0.4 3 Creatinine without ARF points
Select creatinine furthest from 1.0. 0.5-1.4 0
1.5-1.94 4
OR >=1.95 7 OR
Creatinine with ARF* (mg/dl) 0-1.4 0 Creatinine with ARF points
*Acute Renal Failure (ARF) is defined as creatinine >=1.5 mg/dl >=1.5 10 as creatinine >=1.5 mg/dl
and urine output <410 cc/day and no chronic dialysis
Urine Output (cc/day) <=399 15 Urine output points
Enter total for day 400-599 8
600-899 7
900-1499 5
1500-1999 4
2000-3999 0
>=4000 1
BUN (mg/dl) <=16.9 0 BUN points
Select highest BUN (furthest from 0) 17-19 2
20-39 7
40-79 11
>=80 12
Select Sodium furthest from 145.5. 120-134 2
135-154 0
>=155 4
Albumin (g/dl) <=1.9 11 Albumin points
Select albumin furthest from 3.5. 2.0-2.4 6
2.5-4.4 0
>=4.5 4
Bilirubin (mg/dl) <=1.9 0 Bilirubin points
Select highest bilirubin (furthest from 0) 2.0-2.9 5
3.0-4.9 6
5.0-7.9 8
>=8.0 16
Glucose (mg/dl)* <=39 8 Glucose points
Select glucose furthest from 130 40-59 9
*Glucose <=39 mg/dl is lower 60-199 0
weight than 40-59 200-349 3
>=350 5
Acid-Base points (see below) GCS points (see below)
TOTAL APS Score
0Acid-Base Abnormalities* pCO2<25 25-<30 30-<35 35-<40 40-<45 45-<50 50-<55 55-<60 >=60
*Assign score based upon pH-pCO2 pH <7.15
12 4 relationship 7.15-<7.2 7.20-<7.25 9 6 3 2 7.25-<7.30 7.30-<7.35 0 1 7.35-<7.40 5 7.40-<7.45 7.45-<7.50 0 2 7.50-<7.55 7.55-<7.60 7.60-<7.65 0 3 12 >=7.65 Neurological Abnormalities*
*If a patient is anesthetized, under the influence of anesthesia, or totally paralyzed/sedated during the ENTIRE data collection period, attempt to obtain a GCS from the twelve-hour period prior to ICU admission when GCS was able to be assessed. If no assessable GCS is documented during that time period, zero points shhould be assigned. If unable to determine verbal score (due to intubation status or similar barriers), use clinical judgement and assign Glasgow Verbal Score according to the following scale:
alert, oriented 5 confused 3 nonresponsive 1
verbal
confused conversation (4) no response (1) motor 0 3 10 15 3 8 13 15 3 13 24 24 3 13 29 29 verbal
confused conversation (4) no response (1) motor
16 16
24 33
29 48
is documented during that time period, zero points shhould be assigned. If unable to determine verbal score (due to intubation status or similar barriers), use clinical judgement and assign Glasgow Verbal Score according to the following scale:
If patient's eyes open spontaneously (4) or to oriented, converses (5)
inappropriate words, incomp.
sounds (3,2) painful/verbal stimulation (2,3), use scale:
Note: shaded areas represent unlikely clinical combinations. Placing a patient in any of these cells should be done after careful confirmation of clinical findings. obeys verbal commands (6) localizes pain (5) flexion withdrawal/de corticate rigidity (4,3) decerebrate rigidity/no response (2,1)
If patient's eyes do not open spontaneously oriented, converses (5)
inappropriate words, incomp.
sounds (3,2) or to painful/verbal stimulation (1), use scale:
Note: shaded areas represent extremely unlikely clinical combinations, and should not be used. If these combinations are verified in a clinical setting, no prediction should be generated for the patient.
obeys verbal commands (6) localizes pain (5) flexion withdrawal/de corticate rigidity (4,3) decerebrate rigidity/no response (1)
The APACHE III Score is the sum of points assigned to Acute Physiology (the APS Score, Age, and Chronic Health. The predictive models use each of these three components individually, as separate and distinct
variables. Therefore the APACHE III Score is not required for mortality prediction. However, some may find it valuable for other purposes. Enter appropriate point values in the blue box to the right. Fill in blue shaded areas to obtain APACHE III Score
Age of patient Points Total age points:
Select one Under age 16 do not score
<=44 0 45-59 5 60-64 11 65-69 13 70-74 16 75-84 17 >=85 24
Chronic Health Items present on admission Points Total chronic health points
AIDS 23
Select for non-operative or Hepatic Failure 16
emergency surgical patients Lymphoma 13
only, otherwise 0 Metastatic cancer 11
Leukemia/multiple myeloma 10
Immunosuppression 10
Cirrhosis 4
None/not available 0
Acute Physiology Score (from previous worksheet) Total APS score
APACHE III Score 0 If more than one is present, apply
Approver: Kim Hlobik Cardiovascular (CARDIOVASC)
Non-Operative AMI_ANT Infarction, acute myocardial (MI), ANTERIOR
AMI_INFLAT Infarction, acute myocardial (MI), INFEROLATERAL AMI_NONQ Infarction, acute myocardial (MI), NON Q Wave AMI_OTHER Infarction, acute myocardial (MI), none of the above
CVOTH Anaphylaxis
MEDAORT Aneurysm, dissecting aortic PERIART Aneurysm/pseudoaneurysm, other
CHESTPAIN Angina, stable (asymp or stable pattern of symptoms w/meds)
USTAANG Angina, unstable (angina interferes w/quality of life or meds are tolerated poorly)
CARDARR Cardiac arrest (with or without respiratory arrest; for respiratory arrest see Respiratory System) CARDIOMY Cardiomyopathy
CVOTH Cardiovascular medical, other
CHESTPAIN Chest pain, atypical (noncardiac chest pain) CHESTPAIN Chest pain, epigastric
CHESTPAIN Chest pain, musculoskeletal CHESTPAIN Chest pain, respiratory CHESTPAIN Chest pain, unknown origin CHFD CHF, congestive heart failure
CVOTH Complications of previous open heart MULTRAUM Contusion, myocardial (include R/O) CVOTH Efffusion, pericardial
CVOTH Endocarditis
CVOTH Hematomas
HEMORRHAE Hemorrhage (for gastrointestinal bleeding GI-see GI system) (for trauma see Trauma) HYPERT Hypertension, uncontrolled (for cerebrovascular
HYPOVOLEM Hypovolemia (including dehydration. Do NOT include shock states.) CVOTH MI admitted > 24hrs after onset of ischemia
CVOTH Monitoring, hemodynamic (pre-operative evaluation) CARDIOG Papillary muscle rupture
CVOTH Pericarditis
RHYTHM Rhythm disturbance (atrial, supraventricular) RHYTHM Rhythm disturbance (conduction defect) RHYTHM Rhythm disturbance (ventricular)
APACHE Disease Mapping
Approver: Kim Hlobik SEPSISCUT Sepsis, cutaneous/soft tissue
SEPSISGI Sepsis, GI
SEPTICUT Sepsis, gynecologic SEPSISOTH Sepsis, other SEPSISPULM Sepsis, pulmonary
SEPTICUT Sepsis, renal/UTI (including bladder) SEPSISUNK Sepsis, unknown
CARDIOG Shock, cardiogenic CVOTH Tamponade, pericardial
CVOTH Thrombosis, vascular (deep vein) PERIART Thrombus,arterial
DRUGTOXIC Toxicity, drug (i.e., beta blockers, calcium channel blockers, etc.) CVOTH Vascular medical, other
Cardiovascular (CARDIOVASC) Post-Operative
SCARDOTH Ablation or mapping of cardiac conduction pathway SCARDOTH Aneurysm repair, ventricular
SELAORT Aneurysm, abdominal aortic
SAORTDIS Aneurysm, abdominal aortic; with dissection SRUPAOR Aneurysm, abdominal aortic; with rupture SELAORT Aneurysm, thoracic aortic
SAORTDIS Aneurysm, thoracic aortic; with dissection SRUPAORT Aneurysm, thoracic aortic; with rupture
SCARDOTH Aneurysms, repair of other (except ventricular) SVALVE Aortic and Mitral valve replacement
SVALVE Aortic valve replacement (isolated) SCARDOTH Atrial Septal Defect (ASD) Repair
SVHDCABG CABG redo with valve repair/replacement SCABGVALV CABG with aortic valve replacement
SVHDCABG CABG with double valve repair/replacement SCABGVALV CABG with mitral valve repair
SCABGVALV CABG with mitral valve replacement
SCABGVALV CABG with pulmonic or tricuspid valve repair or replacement. SCARDOTH CABG, Minimally invasive; Mid-CABG
SCARDOTH Cardiovascular surgery, other APACHE Disease
Approver: Kim Hlobik SCARDOTH
SCARDOTH
SCARDOTH Congenital Defect Repair (Other)
SCARDOTH Defibrillator, automatic implantable cardiac; insertion of SPERISC Dilatation (with general anesthesia)
SPERISC Dilatation (without general anesthesia) SPERISC Embolectomy (with general anesthesia) SPERISC Embolectomy (without general anesthesia) SCARDOTH Endarterectomy (other vessels)
SCAROTID Endarterectomy, carotid SCARDOTH Graft for dialysis, insertion of SAGRAFT Graft, aorto-femoral bypass SAGRAFT Graft, aorto-iliac bypass SCARDOTH Graft, femoral-femoral bypass SFEMPGRAF Graft, femoral-popliteal bypass SPERISC Grafts, all other bypass (except renal) SPERISC Grafts, all renal bypass
SCARDOTH Grafts, removal of infected vascular SVALVE Mitral valve repair
SVALVE Mitral valve replacement SCARDOTH Pericardial effusion/tamponade SCARDOTH Pericardiectomy (total/subtotal) SVALVE Pulmonary valve surgery
SPERISC Thrombectomy (with general anesthesia) SPERISC Thrombectomy (without general anesthesia) SVALVE Tricuspid valve surgery
SCARDOTH Tumor removal, intracardiac SCARDOTH Vascular surgery, other SCARDOTH Vena cava clipping SCARDOTH Vena cava filter insertion
SCARDOTH Ventricular Septal Defect (VSD) Repair
Genitourinary (GENITOURIN) Non-Operative
RENOTH Genitourinary medical, other
Complications of prev. peripheral vasc. surgery,surgery for (i.e.ligation of bleeder, exploration and evacuation of hematoma, debridement, pseudoaneurysms, clots, fistula, etc.)
Complications of previous open-heart surgery, surgery for (i.e. bleeding, infection, mediastinal rewiring,leaking aortic graft etc.)
APACHE Disease Mapping
Approver: Kim Hlobik CVOTH Hemorrhage, postpartum (female only)
HEPATF Hepato-renal syndrome
HYPERT Pre-eclampsia/eclampsia (female only) RENOTH Renal bleeding
RENOTH Renal failure, acute RENOTH Renal infection/abscess RENOTH Renal neoplasm, cancer RENOTH Renal obstruction
Genitourinary (GENITOURIN) Post-Operative
SRENOTH Bladder repair for perforation/rupture GENOTH Cesarean section
GENOTH Cyst, ruptured ovarian SRENOTH Cystectomy (other reasons) SRENCA Cystectomy for neoplasm GENOTH Ectopic pregnancy (all) GENOTH Exenteration, pelvic -male GENOTH Exenteration, pelvic-female GENOTH Genitourinary surgery, other
SOBHYST Hysterectomy for cancer with or without lymph node dissection SOBHYST Hysterectomy for other benign neoplasm/fibroids
GENOTH Lymph node dissection, pelvic or retroperitoneal(female) GENOTH Lymph node dissection, pelvic or retroperitoneal(male) GENOTH Mastectomy (all)
SRENOTH Nephrectomy (other reasons) SRENCA Nephrectomy for neoplasm
SRENCA Obstruction due to neoplasm ,surgery for; (with or without ileal-conduit) SRENOTH Obstruction due to nephrolithiasis, surgery for (with or without ileal-conduit) SRENOTH Obstruction/other, surgery for (with or without ileal-conduit)
GENOTH Oophorectomy with/without salpingectomy with/without lymph node dissection SRENOTH Orchiectomy with/without pelvic lymph node dissection
GENOTH Pelvic relaxation (cystocele, rectocele, etc.)
SRENOTH Prostatectomy, suprapubic; for benign prostatic hypertrophy SRENCA Prostatectomy, suprapubic; for cancer
SRENOTH TURP, transurethral prostate resection for benign prostatic hypertrophy SRENCA TURP, transurethral prostate resection for cancer
APACHE Disease Mapping
Approver: Kim Hlobik Gastrointestinal (GI)
Non-Operative
OD Alcohol withdrawal
GIBLVAR Bleeding, GI from esophageal varices/portal hpertension GIBLEED Bleeding, GI-location unknown
GIBLEUL Bleeding, lower GI GIBLEED Bleeding, upper GI GINEOP Cancer, colon/rectal GINEOP Cancer, esophageal GINEOP Cancer, other GI GINEOP Cancer, pancreatic
GINEOP Cancer, stomach
GIINFLA Cholangitis
GIINFLA Diverticular disease HEPATF Encephalopathy, hepatic GIINFLA GI Abscess/cyst
GIOTHER GI medical, other GIOBSTR GI Obstruction GIPERF GI Perforation/rupture GIVASC GI Vascular insufficiency
PERITOHEM Hemorrhage, intra/retroperitoneal HEPATF Hepatic failure, acute
GIINFLA Inflammatory bowel disease PANCRE Pancreatitis
GIINFLA Peritonitis
GIOTHER Ulcer disease, peptic
Gastrointestinal (GI) Post-Operative
SGIOTH Appendectomy
SGIBLEE Bleeding-lower GI, surgery for SGIBLEE Bleeding-other GI, surgery for SGIBLEE Bleeding-upper GI, surgery for
SGIBLEE Bleeding-variceal, surgery for (excluding vascular shunting-see surgery for portosystemic shunt) SGICA Cancer-colon/rectal, surgery for (including abdominoperineal resections)
SGICA Cancer-esophageal, surgery for (abdominal approach)
SGICA Cancer-other GI tract, surgery for (i.e. hepatoma, gallbladder etc.) APACHE Disease
Mapping
APACHE Disease Mapping
Approver: Kim Hlobik SGICA Cancer-small intestinal, surgery for
SGICA Cancer-stomach, surgery for SGIOTH CAPD catheter insertion
SGICHOL Cholecystectomy/cholangitis, surgery for (gallbladder removal)
SGIOTH Complications of previous GI surgery; surgery for (anastomotic leak, bleeding, abscess, infection, dehiscence, etc.) SGIINFL Diverticular disease, surgery for
SGIOTH Esophageal surgery, other
SGIABCES Fistula/abscess, surgery for (not inflammatory bowel disease)
SGIOTH Gastrostomy
SGIABCES GI Abscess/cyst-primary, surgery for (for complications of GI surgery see below) SGIOBS GI Obstruction, surgery for (including lysis of adhesions)
SGIPERF GI Perforation/rupture, surgery for SGIOTH GI surgery, other
SGIVASC GI Vascular ischemia, surgery for (resection) SGIOTH Hernia-hiatal, esophageal surgery for
SGIOTH Herniorrhaphy
SGIINFL Inflammatory bowel disease, surgery for SGIOTH Obesity-morbid, surgery for
SGIOTH Pancreatitis, surgery for SGIOTH Peritoneal lavage SGIPERF Peritonitis, surgery for
SGIOTH Shunt, peritoneal-venous;surgery for SGIOTH Shunt-portosystemic, surgery for
SGIOTH Splenectomy
SGICA Whipple-surgery for pancreatic cancer
Hematology (HEMATO) Non-Operative
HEMAMISC Anemia
HEMAMISC Blood transfusion reaction COAGTHRO Coagulopathy
HEMAMISC Hematologic medical, other HEMAMISC Leukemia, acute lymphocytic HEMAMISC Leukemia, acute myelocytic HEMAMISC Leukemia, chronic lymphocytic HEMAMISC Leukemia, chronic myelocytic HEMAMISC Leukemia, other
APACHE Disease Mapping
Approver: Kim Hlobik HEMAMISC Lymphoma, Hodgkins
HEMAMISC Lymphoma, non-Hodgkins COAGTHRO Neutropenia
COAGTHRO Pancytopenia HEMAMISC Sickle cell crisis COAGTHRO Thrombocytopenia
Hematology (HEMATO) Post-Operative HEMAMISC Hematologic surgery, other
HEMAMISC Lymphoma Hodgkins, surgery for (including staging) HEMAMISC Lymphoma, non-Hodgkins; surgery for (including staging)
Metabolic/Endocrine (METAB/ENDO) Non-Operative
ACIDBASE Acid-base electrolyte disturbance METAMISC Addisons disease
GIOTHER Adrenal neoplasm (including pheochromocytoma)
COMAMETU Diabetic hyperglycemic hyperosmolar nonketotic coma (HHNC) DIABETIC Diabetic ketoacidosis
METAMISC Heat exhaustion/stroke METAMISC Hyperthermia
METAMISC Hyperthyroid storm/crisis METAMISC Hypoglycemia
METAMISC Hypothermia
METAMISC Hypothyroid/myxedema
METAMISC Metabolic/endocrine medical, other METAMISC Thyroid neoplasm
Metabolic/Endocrine (METAB/ENDO) Post-Operative
HEMAMISC Adrenalectomy
HEMAMISC Metabolic/endocrine surgery, other HEMAMISC Parathyroidectomy
HEMAMISC Thyroidectomy and parathyroidectomy HEMAMISC Thyroidectomy
Musculoskeletal/Skin (MUSKELSKIN) Non-Operative
GENOTH Arthritis, rheumatoid APACHE Disease Mapping APACHE Disease Mapping APACHE Disease Mapping APACHE Disease Mapping
Approver: Kim Hlobik GENOTH Arthritis, septic
PERIART Cellulitis and localized soft tissue infections GENOTH Connective tissue disease (mixed)
GENOTH Lupus, systemic
GENOTH Musculoskeletal medical, other GENOTH Myositis, viral
GENOTH Rhabdomyolysis
GENOTH Scleroderma
GENOTH Vasculitis
Musculoskeletal/Skin (MUSKELSKIN) Post-Operative
SAMPUTATE Amputation (non-traumatic)
SPERISC Cellulitis and localized soft tissue infections, surgery for GENOTH Cosmetic surgery (all)
GENOTH Fracture-pathological, non-union, non-traumatic, for fractures due to trauma see Trauma GENOTH Grafting, skin (all)
GENOTH Hip replacement, total (non-traumatic) GENOTH Knee replacement, total (non-traumatic) GENOTH Orthopedic surgery, other
GENOTH Skin surgery, other
Neurologic (NEUROLOGIC) Non-Operative NEURINF Abscess, neurologic
NEURMUS Amyotrophic lateral sclerosis
COMAMETU Coma/change in level of consciousness (for hepatic see GI, for diabetic see Endocrine, if related to cardiac arrest, see CV) STROKE CVA, cerebrovascular accident/stroke
OD Drug withdrawal
NEURINF Encephalitis
COMAMETU Encephalopathies (excluding hepatic) NEURMUS Guillian-Barre syndrome
SAHMED Hematoma, epidural SAHMED Hematoma, subdural
ICHMED Hemorrhage/hematoma, intracranial NEUROTH Hydrocephalus, obstructive
NEURINF Meningitis
NEURMUS Myasthenia gravis APACHE Disease
Mapping
APACHE Disease Mapping
Approver: Kim Hlobik NEONEUR Neoplasm, neurologic
NEUROTH Neurologic medical, other NEURMUS Neuromuscular medical, other
CARDARR Nontraumatic coma due to anoxia/ischemia
OD Overdose, alcohols (bethanol, methanol, ethylene glycol) OD Overdose, analgesic (aspirin, acetaminophen)
OD Overdose, antidepressants (cyclic, lithium) OD Overdose, other toxin, poison or drug
OD Overdose, sedatives, hypnotics, antipsychotics, benzodiazepines OD Overdose, street drugs (opiates, cocaine, amphetamine)
CARDARR Poisoning, carbon monoxide, arsenic, cyanide SEIZ Seizures (primary-no structural brain disease)
SAHICH Subarachnoid hemorrhage/arteriovenous malformation SAHICH Subarachnoid hemorrhage/intracranial aneurysm
Neurologic (NEUROLOGIC) Post-Operative SNEUROTH Abscess/infection-cranial, surgery for
SNEUROTH Anastomosis, vascular
SNEUROTH Arteriovenous malformation, surgery for SNEUROTH Biopsy, brain
SNEUROTH Burr hole placement
SNEUROTH Cerebrospinal fluid leak, surgery for
SLAMINE Complications of previous spinal cord surgery, surgery for SNEUROTH Cranial nerve, decompression/ligation
SNEUROTH Cranioplasty and complications from previous craniotomies SLAMINE Devices for spine fracture/dislocation
SLAMINE Fusion-spinal/Harrington rods SSDH Hematoma, epidural, surgery for SSDH Hematoma, subdural, surgery for
SICH Hemorrhage/hematoma-intracranial, surgery for
SLAMINE Laminectomy/spinal cord decompression (excluding malignancies) SCRANNEO Neoplasm-cranial, surgery for (excluding transphenoidal)
SLAMINE Neoplasm-spinal cord surgery or other related procedures SNEUROTH Neurologic surgery, other
SNEUROTH Seizures-intractable, surgery for SNEUROTH Shunts and revisions
APACHE Disease Mapping
Approver: Kim Hlobik SLAMINE Spinal cord sugery, other
SNEUROTH Stereotactic procedure
SSAH Subarachnoid hemorrhage/intracranial aneurysm, surgery for
SLAMINE Sympathectomy
SCRANNEO Transphenoidal surgery SNEUROTH Ventriculostomy
Respiratory (RESPIRAT) Non-Operative RESPOTH Apnea, sleep
PULEDEM ARDS-adult respiratory distress syndrome, non-cardiogenic pulmonary edema RESPARR Arrest, respiratory (without cardiac arrest)
ALLERGY Asthma
RESPOTH Atelectasis RESPCA Cancer, laryngeal
RESPCA Cancer, lung
RESPCA Cancer, oral RESPCA Cancer, tracheal PLEUREFFUS Effusions, pleural PULEMB Embolus, pulmonary
COPD Emphysema/bronchitis
RESPOTH Hemorrhage/hemoptysis, pulmonary
RESPOTH Hemothorax
RESPOTH Hypertension-pulmonary, primary/idiopathic RESPOTH Near drowning accident
AIROBS Obstruction-airway (i.e. acute epiglottitis, post-extubation edema, foreign body, etc.) ASPPNEU Pneumonia, aspiration
BACPNEU Pneumonia, bacterial PARAPNEU Pneumonia, fungal BACPNEU Pneumonia, other
PARAPNEU Pneumonia, parasitic (i.e. Pneumocystis pneumonia) BACVPNEU Pneumonia, viral
RESPOTH Pneumothorax
RESPOTH Respiratory- medical, other
RESLUNGDIS Restrictive lung disease (i.e. sarcoidosis, pulmonary fibrosis) RESPOTH Smoke inhalation
RESPOTH Weaning from mechanical ventilation (transfer from other unit or hospital only) APACHE Disease
Approver: Kim Hlobik Respiratory (RESPIRAT)
Post-Operative SRESTOTH Apnea-sleep; surgery for (i.e. UPPP -uvulopalatopharyngoplasty)
SLUNG Biopsy, open lung
SRESOTH Bullectomy
SRESPLAR Cancer oral/sinus, surgery for
SRESPLAR Cancer-laryngeal/tracheal, surgery for
SRESOTH Facial surgery (if related to trauma, see Trauma) SRESPINF Infection/abscess, other surgery for
SRESOTH Respiratory surgery, other
SRESPCA Thoracotomy for benign tumor (i.e. mediastinal chest wall mass, thymectomy SRESOTH Thoracotomy for bronchopleural fistula
SGICA Thoracotomy for esophageal cancer SRESPCA Thoracotomy for lung cancer SRESOTH Thoracotomy for lung reduction
SRESPCA Thoracotomy for other malignancy in chest SRESOTH Thoracotomy for other reasons
SLUNG Thoracotomy for pleural disease
SRESPINF Thoracotomy for thoracic/respiratory infection
SRESOTH Tracheostomy
APACHE Disease Transplant (TRANSPLANT)
Mapping Non-Operative
RENOTH Kidney transplant HEPATF Liver transplant
NON-PREDICTIVE ALL OTHER NON_OPERATIVE TRANSPLANTS
Transplant (TRANSPLANT) Post-Operative SRENTRAN Kidney transplant
SLIVERTR Liver transplant
NON-PREDICTIVE ALL OTHER POST-OPERATIVE TRANSPLANTS
Trauma (TRAUMA) Non-Operative MULTRAUM Abdomen only trauma
MULTRAUM Abdomen/extremity trauma MULTRAUM Abdomen/face trauma MULTRAUM Abdomen/multiple trauma
APACHE Disease Mapping APACHE Disease Mapping APACHE Disease Mapping
Approver: Kim Hlobik MULTRAUM Abdomen/pelvis trauma
MULTRAUM Abdomen/spinal trauma MULTRAUM Chest/abdomen trauma MULTRAUM Chest/extremity trauma MULTRAUM Chest/face trauma TRAUMCHSP Chest/multiple trauma MULTRAUM Chest/pelvis trauma TRAUMCHSP Chest/spinal trauma MULTRAUM Chest/thorax only trauma MULTRAUM Extremity only trauma MULTRAUM Extremity/face trauma MULTRAUM Extremity/multiple trauma MULTRAUM Face only trauma
MULTRAUM Face/multiple trauma TRHEADONLY Head (CNS) only trauma HEADTR Head/abdomen trauma HEADTR Head/chest trauma TRHEADEXF Head/extremity trauma TRHEADEXF Head/face trauma TRHEADMULT Head/multiple trauma HEADTR Head/pelvis trauma HEADTR Head/spinal trauma MULTRAUM Pelvis/extremity trauma MULTRAUM Pelvis/face trauma MULTRAUM Pelvis/hip only trauma MULTRAUM Pelvis/multiple trauma MULTRAUM Pelvis/spinal trauma TRAUMSPINE Spinal cord only trauma MULTRAUM Spinal/extremity trauma MULTRAUM Spinal/face trauma MULTRAUM Spinal/multiple trauma MULTRAUM Trauma medical, other
Trauma (TRAUMA) Post-Operative SMULTR Abdomen only trauma, surgery for
SMULTR Abdomen/extremity trauma, surgery for APACHE Disease
Approver: Kim Hlobik SMULTR Abdomen/face trauma, surgery for
SMULTR Abdomen/multiple trauma, surgery for SMULTR Abdomen/pelvis trauma, surgery for SMULTR Abdomen/spinal trauma, surgery for SMULTR Chest/abdomen trauma, surgery for SMULTR Chest/extremity trauma, surgery for SMULTR Chest/face trauma, surgery for SMULTR Chest/multiple trauma, surgery for SMULTR Chest/pelvis trauma, surgery for SMULTR Chest/spinal trauma, surgery for SMULTR Chest/thorax only trauma, surgery for STRAUMEXT Extremity only trauma, surgery for SMULTR Extremity/face trauma, surgery for SMULTR Extremity/multiple trauma, surgery for SMULTR Face only trauma, surgery for
SMULTR Face/multiple trauma, surgery for STRHDONLY Head (CNS) only trauma, surgery for SHEADTR Head/abdomen trauma, surgery for SHEADTR Head/chest trauma, surgery for SHEADTR Head/extremity trauma, surgery for SHEADTR Head/face trauma, surgery for SHEADTR Head/multiple trauma, surgery for SHEADTR Head/pelvis trauma, surgery for SHEADTR Head/spinal trauma, surgery for SMULTR Pelvis/extremity trauma, surgery for SMULTR Pelvis/face trauma, surgery for SMULTR Pelvis/hip only trauma,surgery for SMULTR Pelvis/multiple trauma, surgery for SMULTR Pelvis/spinal trauma, surgery for SMULTR Spinal cord only trauma, surgery for SMULTR Spinal/extremity trauma, surgery for SMULTR Spinal/face trauma, surgery for SMULTR Spinal/multiple trauma, surgery for SMULTR Trauma surgery, other
APACHE IV HOSPITAL MORTALITY NON-CABG PATIENT OValue Coefficient Knot Points Cross Product Intercept 1 -5.950471952 -5.9504719516 Age Age 00.0241774552 0 AGE1 0 -4.3886E-006 27 0 AGE2 0 5.01422E-005 51 0 AGE3 0 -0.000127787 64 0 AGE4 0 0.000109606 74 0 AGE5 0 -2.7572E-005 86 0
Chronic Health (0/1)* None 0
For non-op and emergency AIDS 0.9581005157 0
surgery pts., select item used Hepatic Failure 1.0373799253 0
to calculate APACHE III score. Lymphoma 0.743471748 0
If multiple chronic health items are presenMetastatic Cancer 1.0864237522 0
use the one with the highest point value (Leukemia/Multiple Myeloma 0.9693082989 0
APACHE IV spreadsheet), NOT the one wit Immunosuppression 0.4355810827 0
the highest coefficient. Cirrhosis 0.8146650877 0
0
Acute Physiology Score APS 00.0556349159 0
APS3ALL1 0 8.71852E-006 10 0
Enter the Acute Physiology APS3ALL2 0 -4.5110E-005 22 0
Score. Splining of this variable APS3ALL3 0 0.00005038 32 0
will autocalculate APS3ALL APS3ALL4 0 -1.3123E-005 48 0
APS3ALL5 0 -8.6535E-007 89 0
PA/FI Ratio -0.000397068 0
Ventilated at any time during ICU Day 1 1=Yes 0.2717600356 0
ICU Admission Information (0/1) Adm to ICU from floor 0.0171491928 0
Select only one 0.0221062655 0
Admit to ICU from OR/PACU -0.583828121 0
0 Transfer to ICU from other hospital
Emergency Surgery 0/1 0.2490734585 0
PreICU LOS in days
square root of days (aut 0 -0.310487496 0
PRELOS21 01.4746725115 0.121 0
PRELOS22 0 -2.8618857 0.423 0
PRELOS23 01.4216590103 0.794 0
PRELOS24 0 -0.034445822 2.806 0
Admitting Diagnosis* ACIDBASE -0.640575517 0
*See mapping table AIROBS -0.977669154 0
*Select only one ALLERGY -1.540678498 0
AMI_ANT 0.1029497654 0 AMI_INFRLATR -0.152525079 0 AMI_NONQ -0.270872458 0 ASPPNEU -0.37223658 0 BACPNEU -0.043365914 0 BACVPNEU 0.2543749044 0 CARDARR 0.4169191406 0 CARDIOG 0.2397114719 0 CARDIOMY 0.0599624438 0 CHESTPAIN -1.122354572 0 CHFD -0.422587793 0 COAGTHRO 0.2581724351 0 COMAMETU -0.927156778 0 COPDD -0.398697453 0 CVOTH -0.369658509 0 DIABETIC -1.775702142 0 DRUGTOXIC -0.690943246 0 GENOTH -0.667576408 0 GIBLEED -0.551832894 0
# Days between ICU and Hosp Admission
GIBLEUL -0.579471867 0 GIBLVAR -0.527719358 0 GIINFLA -0.211771894 0 GINEOP 0.1951302908 0 GIOBSTR -0.369945003 0 GIOTHER -0.252586643 0 GIPERF -0.327171182 0 GIVASC 0.714879336 0 HEADTR -0.372350315 0 HEMAMISC -0.342352862 0 HEMORRHAGE -0.656757432 0 HEPATF -0.119675791 0 HYPERT -0.813921325 0 HYPOVOLEM -0.622592285 0 ICHMED 0.9450561547 0 MEDAORT 0.6491493051 0 METAMISC -0.986438209 0 MULTRAUM -0.678110274 0 NEONEUR 0.0189527274 0 NEURINF -0.535783229 0 NEURMUS -0.550653067 0 NEUROTH -0.176828697 0 OD -1.55261952 0 PANCRE -0.513627563 0 PARAPNEU 1.0561873472 0 PERIART -0.502752032 0 PERITOHEM -0.659544401 0 PLEUREFFUS 0.1899005237 0 PULEDEM -0.2416873 0 PULEMB -0.051527401 0 RENOTH -0.54158014 0 RESLUNGDIS 1.5552965796 0
RESPARR -0.390631425 0 RESPCA 0.966313802 0 RESPOTH -0.202823617 0 RHYTHM -0.603060945 0 SAGRAFT -0.831194514 0 SAHICH 0.6159503846 0 SAHMED 0.2950939014 0 SAMPUTATE 0.604910303 0 SAORTDIS -0.178456475 0 SCABGVALV -1.199434806 0 SCARDOTH -0.59044574 0 SCAROTID -1.332642438 0 SCRANNEO -0.437737676 0 SEIZ -0.942170992 0 SELAORT -0.760703396 0 SEPSISCUT 0.1264403154 0 SEPSISGI -0.13010935 0 SEPSISOTH -0.04233671 0 SEPSISPULM -0.258766455 0 SEPSISUNK -0.093377498 0 SEPTICUT -0.732788506 0 SFEMPGRAF -0.786571016 0 SGIABCES -0.556661177 0 SGIBLEE -0.329679773 0 SGICA 0.1362826618 0 SGICHOL -0.593293673 0 SGIINFL -0.165585527 0 SGIOBS -0.189005132 0 SGIOTH -0.295894316 0 SGIPERF -0.189960264 0 SGIVASC 0.4983280142 0 SHEADTR 0.3577977348 0
SICH 0.5267174102 0 SLAMINE -0.628609547 0 SLIVERTR -1.370278559 0 SLUNG 0.4057380077 0 SMULTR -0.377807998 0 SNEUROTH 0.0039963394 0 SOBHYST -0.795847883 0 SPERISC -0.504208244 0 SRENCA -1.397212695 0 SRENOTH -0.693574061 0 SRENTRAN -1.308449407 0 SRESOTH -0.249217228 0 SRESPCA 0.086933576 0 SRESPINF -0.005937516 0 SRESPLAR -1.152870135 0 SRUPAOR 0.204404736 0 SSAH 0.318905704 0 SSDH 0.7156826217 0 STRAUMEXT -0.180386981 0 STRHDONLY 1.0888193243 0 STROKE 0.5194530354 0 SVALVE -1.371763972 0 SVHDCABG -0.155141644 0 TRAUMCHSP -0.717432122 0 TRAUMSPINE 0.0337694835 0 TRHEADEXF -0.364128015 0 TRHEADMULT -0.067960926 0 TRHEADONLY 0.5958694161 0 USTAANG -1.212730735 0 0 0
Unable to obtain GCS (Unable = 1) 0.7857643165 0
GCS Eyes + Motor + Verbal
Adjusted GCS (autocalc) 00.0391175318 0
Sum of cross products -5.9504719516
Natural antilog of sum =x 0.002604611
Prediction = x/(1+x)
0.26%
Note: Predictions after the initial day contain an additional variable that updates the patient's APACHE III score for changes in physiological status, and the relative contributions of age and comorbidities are also different on subsequent days. These equations are intended to be used to generate predictions.
due to meds, sedation, or anesthesia. See methodology for rules.
HOSPITAL MORTALITY-CABG Only CABG Patient Only Value Coefficient Knot PointCross Product
Intercept 1 -7.246664 -7.246664
Age (0/1) Select one <45 0 0 0
45-54 0 -0.737078 0 55-59 -0.765009 0 60-64 -0.529345 0 65-69 -0.222009 0 70-74 0.107859 0 75-84 0.169567 0 >=85 0.765707 0 0
Chronic Health Do not use chronic
health items for CABG mortality prediction.
Acute Physiology Score APS 0 0.044207 0 Internal calculations, do not change
Enter the Acute Physiology EQ18_APS3ALL1 0 0.17313 15 0 0 0 0
Score. Splining of this variable EQ18_APS3ALL2 0 -0.041316 30 0 0 0 0
will autocalculate APS3ALL EQ18_APS3ALL3 0 -1.145473 40 0 0 0 0
EQ18_APS3ALL4 0 1.713847 50 0 0 0 0
Internal calculations, kd 17.784467 60
do not change diff 30 90
Emergency Surgery 0/1 0 0.76644 0
CABG-Specific Variables Female (yes=1) 0 0.861304 0
Enter all that apply Redo CABG (yes=1) 1.206335 0
Sum of cross products -7.246664
Natural antilog of sum =x 0.00071255
Prediction = x/(1+x)
0.07%
Note: Predictions after the initial day contain an additional variable that updates the patient's APACHE III score for changes in physiological status, and the relative contributions of age and comorbidities are also different on subsequent days. This equation is intended to be used to generate predictions.
APACHE IV ICU LENGTH OF STAY NON CABG Patient Only Value Coefficient Knot Points Cross Product
Intercept 1 1.6738879246 1.6738879246
Age (0/1) Select one Age 0.0176033952 0
AGE1 0 -7.6826E-006 27 0
AGE2 0 3.95667E-005 51 0
AGE3 0 -0.000166793 64 0
AGE4 0 0.0002281564 74 0
AGE5 0 -9.3248E-005 86 0
Chronic Health (0/1)* None 0 0
For non-op and emergency AIDS -0.10285942 0
surgery pts., select item used Hepatic Failure -0.16012995 0
to calculate APACHE III score. Lymphoma -0.28079854 0
If multiple chronic health items are present,Metastatic Cancer -0.491932974 0
use the one with the highest point value (seLeukemia/Multiple Myeloma -0.803754341 0
APACHE IV spreadsheet), NOT the one with Immunosuppression -0.07438064 0
the highest coefficient. Cirrhosis 0.3626586131 0
0
Acute Physiology Score APS 0.0444269895 0
APS3ALL1 0 -5.8305E-005 10 0
Enter the Acute Physiology APS3ALL2 0 0.0002970084 22 0
Score. Splining of this variable APS3ALL3 0 -0.000404434 32 0
will autocalculate APS3ALL APS3ALL4 0 0.0001892508 48 0
APS3ALL5 0 -2.3520E-005 89 0
PaO2/FIO2 Ratio -0.004581842 0
Ventilated at any time during ICU Day 1 1=Yes 1.8353095408 0
ICU Admission Information (0/1) Adm to ICU from floor 0.0065293818 0
Select only one 0.8555050425 0
Admit to ICU from OR/PACU -0.599591763 0
Transfer to ICU from other hospital
0
Readmit 0/1 0.5403684594 0
Emergency Surgery 0/1 1.0406906318 0
PreICU LOS in days 0
square root of days (autocalc) 0 0.4598231293 0
PRELOS21 0 0.3977919374 0.121 0
PRELOS22 0 -0.945210953 0.423 0
PRELOS23 0 0.5886512665 0.794 0
PRELOS24 0 -0.041232251 2.806 0
Admitting Diagnosis* ACIDBASE -0.382017407 0
*See mapping table AIROBS 0.3471484637 0
*Select only one ALLERGY -0.542185912 0
AMI_ANT 0.0857685121 0 AMI_INFRLATR -0.036016015 0 AMI_NONQ -0.057916835 0 ASPPNEU 0.8602584271 0 BACPNEU 1.3067446009 0 BACVPNEU 1.1560647567 0 CARDARR -0.751470488 0 CARDIOG 0.3299898856 0 CARDIOMY 0.5570053879 0 CHESTPAIN -0.520128136 0 CHFD -0.219091549 0 COAGTHRO 0.3998174157 0 COMAMETU -0.081962609 0 COPDD -0.446092483 0 CVOTH -0.132883369 0 DIABETIC -0.58421484 0 DRUGTOXIC -0.882634505 0
# Days between ICU and Hosp Admission
GENOTH -0.420843422 0 GIBLEED 0.0213604052 0 GIBLEUL 0.1856965939 0 GIBLVAR -0.083385343 0 GIINFLA 0.532982522 0 GINEOP 1.3368312875 0 GIOBSTR 2.0686144603 0 GIOTHER 0.5565887447 0 GIPERF 2.2086995672 0 GIVASC 1.9440608345 0 HEADTR 2.1289081715 0 HEMAMISC -0.126173954 0 HEMORRHAGE -0.381155309 0 HEPATF 0.1949458349 0 HYPERT -0.067961418 0 HYPOVOLEM -0.389881468 0 ICHMED 0.8632948203 0 MEDAORT 1.3106215068 0 METAMISC -0.363969853 0 MULTRAUM 1.5211879362 0 NEONEUR 0.9748471868 0 NEURINF 1.1655653196 0 NEURMUS 3.9256604297 0 NEUROTH 0.3575043808 0 OD -0.89006849 0 PANCRE 2.7626886748 0 PARAPNEU 1.6197005464 0 PERIART 0.8443265288 0 PERITOHEM 0.1652656354 0 PLEUREFFUS 0.8100930286 0 PULEDEM 1.4427509398 0 PULEMB 0.1068340489 0
RENOTH -0.152233731 0 RESLUNGDIS 1.024903996 0 RESPARR -0.053291846 0 RESPCA -0.140474342 0 RESPOTH 0.2404909089 0 RHYTHM -0.302546395 0 SAGRAFT 0.5239223901 0 SAHICH 3.0086087597 0 SAHMED 1.1953150967 0 SAMPUTATE -0.325703861 0 SAORTDIS 1.1100214568 0 SCABGVALV -1.358289429 0 SCARDOTH -1.28358348 0 SCAROTID -0.14649332 0 SCRANNEO 0.319065119 0 SEIZ -0.330810671 0 SELAORT 0.7739464631 0 SEPSISCUT 1.5642195701 0 SEPSISGI 1.2453136733 0 SEPSISOTH 0.6490771069 0 SEPSISPULM 1.9266479992 0 SEPSISUNK 0.4025902569 0 SEPTICUT 0.4531372416 0 SFEMPGRAF -0.204188913 0 SGIABCES 0.7199377967 0 SGIBLEE -0.045403893 0 SGICA 0.3248658754 0 SGICHOL -0.588512311 0 SGIINFL 0.6869364416 0 SGIOBS 0.1873047354 0 SGIOTH 0.2170447191 0 SGIPERF 1.0553746251 0
SGIVASC 0.6206952495 0 SHEADTR 3.20631279 0 SICH 2.9498695693 0 SLAMINE -0.251392367 0 SLIVERTR -0.848656603 0 SLUNG 0.1859748668 0 SMULTR 1.4854303079 0 SNEUROTH 0.5513312249 0 SOBHYST -0.162493249 0 SPERISC 0.1022934618 0 SRENCA -0.423760975 0 SRENOTH -0.58901834 0 SRENTRAN -0.556650506 0 SRESOTH -0.359443815 0 SRESPCA 0.1999254548 0 SRESPINF 0.044451048 0 SRESPLAR -0.053892181 0 SRUPAOR 2.7766388797 0 SSAH 2.599592539 0 SSDH 1.3423449617 0 STRAUMEXT -0.481004907 0 STRHDONLY 2.1021826433 0 STROKE 0.3132337931 0 SVALVE -2.076438218 0 SVHDCABG -0.332456954 0 TRAUMCHSP 2.574268317 0 TRAUMSPINE 2.1681426709 0 TRHEADEXF 0.8600333425 0 TRHEADMULT 3.6375602953 0 TRHEADONLY 0.834081141 0 USTAANG -0.368981979 0 0
IF diagnosis is ACUTEMI Thrombolytic Therapy 0.062385214 0
Unable to obtain GCS (Unable = 1) 1.7893266131 0
GCS Eyes + Motor + Verbal
Adjusted GCS (autocalc) 0 -0.015182904 0
Sum of cross products 1.6738879246
Prediction (days)
1.67
Note: Length of Stay predictions are intended to be used to generate ICU length of stay predictions on Day 1 of the patient's stay ONLY.
due to meds, sedation, or anesthesia. See methodology for rules.
ICU Length of Stay-CABG ONLY CABG Patient Only Value Coefficien Knot PointCross Product
Intercept 1 2.004583 2.004583
Age (0/1) Select one AGE 0.012994 0
EQ18_AGE1 0 -8.19E-06 46 0
EQ18_AGE2 0 5.92E-05 59 0
EQ18_AGE3 0 -0.000181 67 0
EQ18_AGE4 0 0.000189 73 0
EQ18_AGE5 0 -5.94E-05 81 0
Chronic Health Do not use chronic health health items for CABG mortality prediction.
Diabetes (medication dependent) (yes=1) 0 0.159896 0
Acute Physiology Score APS -0.02843 0
Enter the Acute Physiology EQ18_APS3ALL1 0 0.000126 15 0 Score. Splining of this variable EQ18_APS3ALL2 0 -0.000295 25 0 will autocalculate APS3ALL EQ18_APS3ALL3 0 0.000167 32 0
EQ18_APS3ALL4 0 -1.04E-06 40 0 EQ18_APS3ALL5 0 2.85E-06 61 0 Emergency Surgery 0/1 0 0.284642 0 Creatinine CREA -0.004945 0 EQ18_CREA1 0 -3.581329 0.6 0 EQ18_CREA2 0 21.94124 0.8 0 EQ18_CREA3 0 -608.0213 1.09 0 EQ18_CREA4 0 591.272 1.1 0 EQ18_CREA5 0 -1.610631 1.9 0
Ejection Fraction PLVEJECT 0 -0.005927 0 EQ18_PLVEJECT1 0 -7.65E-06 20 0 EQ18_PLVEJECT2 0 0.000136 45 0 EQ18_PLVEJECT3 0 -0.000334 54.21552 0 EQ18_PLVEJECT4 0 0.000211 60 0 EQ18_PLVEJECT5 0 5.06E-06 99 0
CABG-Specific Variables Female (yes=1) 0.278597 0
Enter all that apply Redo CABG (yes=1) 0.336221 0
IMA used (yes=1) -0.197821 0
MIDUR (yes=1) 0.214881 0 Number of grafts = 2 0.052944 0 Number of grafts = 3 0.111277 0 Number of grafts = 4 -0.053388 0 Number of grafts = 5 -0.233051 0 Number of grafts = 6 -0.437164 0 Number of grafts >=7 0 -0.482726 0 0
Sum of cross products 2.004583
Prediction =
2.00
Note: Predictions after the initial day contain an additional variable that updates the patient's APACHE III score for changes in physiological status, and the relative contributions of age and comorbidities are also different on subsequent days. This equation is intended to be used to generate hospital mortality prediction on Day 1 of the patient's ICU stay ONLY. Using these coefficients for other days is inappropriate