Edwards A T, Ng K J, Shandall A A, Price-Thomas J M
Department of Surgery, Royal Gwent Hospital, Newport, UK.
J R Coll Surg Edinb. 1991 Feb;36(1):37-40.
The APACHE II system, a severity of disease scoring system, has been used to identify intensive therapy unit patients in whom prolonged treatment is unlikely to be beneficial. Fifty-nine surgical patients admitted to the intensive care unit over a 6-month period underwent a single APACHE II scoring in the first 24 h. The overall 30-day mortality rate was 34%. The range of APACHE II scores was 3-29. The survivors had significantly lower scores (mean 11) than those who died (mean 19). Most patients (53%) had a score greater than or equal to 11 to less than or equal to 22 and had an equal chance of living or dying. No patient with a score greater than 22 survived and at this level the APACHE II score was highly specific (100%) but with a very low sensitivity (30%). APACHE II scores greater than 22 may be useful as an adjunct to a clinical decision to withhold treatment, but scores below that level lack the specificity and sensitivity to be of any value.
急性生理学及慢性健康状况评分系统（APACHE II）是一种疾病严重程度评分系统，已被用于识别那些延长治疗可能无益处的重症监护病房患者。在6个月的时间里，59名入住重症监护病房的外科患者在最初24小时内接受了一次APACHE II评分。30天的总体死亡率为34%。APACHE II评分范围为3 - 29分。幸存者的评分（平均11分）显著低于死亡者（平均19分）。大多数患者（53%）的评分大于或等于11分且小于或等于22分，其存活或死亡的几率相等。评分大于22分的患者无一存活，在此水平上，APACHE II评分具有高度特异性（100%），但敏感性非常低（30%）。大于22分的APACHE II评分可作为停止治疗临床决策的辅助手段，但低于该水平的评分缺乏特异性和敏感性，无任何价值。
