Wong D T, Knaus W A
Department of ICU Research, George Washington University Medical Center, Washington, DC 20037.
Can J Anaesth. 1991 Apr;38(3):374-83. doi: 10.1007/BF03007629.
The APACHE (Acute Physiology and Chronic Health Evaluation) prognostic scoring system was developed in 1981 at the George Washington University Medical Center as a way to measure disease severity. APACHE II, introduced in 1985, was a simplified modification of the original APACHE. The APACHE II score consisted of three parts: 12 acute physiological variables, age and chronic health status. Probability of death can be derived by using the disease category and the APACHE II score. The uses of APACHE II include risk stratification to account for case mix in clinical studies, comparison of the quality of care among ICUs, and assessment of group and individual prognoses. APACHE III, a refinement of APACHE II, will be introduced in late 1990. The APACHE III data base includes 17,457 patients from a representative sample of 40 American hospitals. Additional potential uses of APACHE III include the identification of factors in the ICU which contribute to outcome and assistance in individual patient decision-making. This article reviews the development, current uses and potential applications of the APACHE system.
急性生理与慢性健康评估（APACHE）预后评分系统于1981年由乔治·华盛顿大学医学中心开发，作为一种衡量疾病严重程度的方法。1985年推出的APACHE II是对原始APACHE的简化改进。APACHE II评分由三部分组成：12个急性生理变量、年龄和慢性健康状况。死亡概率可通过疾病类别和APACHE II评分得出。APACHE II的用途包括在临床研究中进行风险分层以考虑病例组合、比较重症监护病房（ICU）之间的护理质量以及评估群体和个体预后。APACHE III是APACHE II的改进版本，将于1990年末推出。APACHE III数据库包括来自美国40家医院代表性样本的17457名患者。APACHE III的其他潜在用途包括识别ICU中影响预后的因素以及协助个体患者决策。本文回顾了APACHE系统的发展、当前用途和潜在应用。
