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A critical study of the APACHE II scoring system using earlier data collection.
  1. M Waters,
  2. P Nightingale,
  3. J D Edwards
  1. Department of Accident and Emergency Medicine, University Hospital of South Manchester, England.


    The APACHE II severity of illness scoring system was prospectively studied on 756 patients admitted to a general intensive care unit (ICU) from January 1986 to June 1988. Admission data were used. Individual and group risk of death were calculated for 3 diagnostic categories commonly seen in the A&E department and requiring admission to an ICU. The APACHE II score on admission tended to underestimate the risk of death following operative and non-operative trauma, and self-poisoning. This may have been related to the use of an analysis not yet validated against values obtained on admission to ICU. Such validation is urgently needed on a UK population if APACHE II scoring is to be of value in the A&E department.

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