APACHE versus SOFA scoring systems
OVERVIEW
- APACHE and SOFA are scoring systems that are commonly used in intensive care
- APACHE = Acute Physiology, Age and Chronic Health Evaluation (I-IV)
- SOFA = Sequential Organ Failure Assessment
APACHE VERSUS SOFA
| 1 | 2 | 3 |
|---|---|---|
| Feature | APACHE | SOFA |
| Basis | Three factors that influence outcome in critically ill patients
| Degree of organ dysfunction is related to acute illness(initially based on sepsis related organ dysfunction but later validated for organ dysfunction not related to sepsis) |
| Score | Physiological variable, chronic health conditions, emergency / elective admissions, and post-operative / non-operative admissions | Defined score (1-4) for each of six organ systems
|
| Scoring duration | Based on the most abnormal measurements in the first 24 hours of ICU stay | Daily scoring of individual and composite scores possible during course of ICU stay |
| Population outcome comparison | Standardized mortality ratios can be used for large patient populations | No predicted mortality algorithm. In general, higher SOFA score is associated with worse outcome.Treatment effects on SOFA |
| Individual patient outcomes | Not possible to predict individual patient outcome or response to therapy | Response of organ dysfunction to therapy can be followed over time |
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC