Health & Medical intensive care

Ask the Experts - Use of APACHE Scoring

´╗┐Ask the Experts - Use of APACHE Scoring
I have no experience with acute physiology and chronic health evaluation (APACHE) II scores, but in my ignorance I do have 2 questions. Has APACHE scoring ever been used to deny a critical patient an ICU bed because he or she was just not expected to make it (ie, the cost-benefit analysis would suggest that further expensive care would be a waste of money)? Wouldn't an abnormal score be justification for earlier emergent and expensive interventions because the patient will surely die without them?

R. Hyden, MD

I know of no institutions or entities that deny ICU beds/care to patients who have an extremely high-acuity APACHE II score. However, more information can be obtained by direct inquiry to Apache Medical Systems, Inc.:

Suite 300
1650 Tysons Blvd.
McLean, Virginia 22102
Phone: (703) 847-1400

Yes, it would seem intuitive that ICU admission and more intensive care would be best in order for patients to survive, but the answer to this question would need to be considered on a diagnosis/prognosis-to-diagnosis/prognosis basis, as this may differ from patient to patient or due to the total constellation of abnormalities/problem list.

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