Acute Physiology and Chronic Health Evaluation Apache II - An ICU Scoring Tool to Assess Critically Ill.

The Acute Physiology and Chronic Health Evaluation (APACHE II) is the severity score and mortality estimation tool developed for use in ICU’s around the world. It is calculated during the first twenty four hours of admission of the patient to an ICU. An integer score ranges from values 0 to 71. During the stay, the score is not recalculated; and by definition, is an admission score.METHODSThis is a cross sectional study done on 100 patients admitted in the medical ICU in Sri Ramachandra Institute of Higher Education and Research.RESULTSOur results showed an APACHE II score of 16.5 which was significant and values equal to and higher than that correlated with the severity of illness.CONCLUSIONSAPACHE II score is a good predictor of mortality in acute respiratory failure patients. It is a useful audit tool which helps the healthcare professionals to interpret and compare their care performance over time.

Psychiatric morbidity among dermatology inpatients.

BACKGROUND: Research on psychiatric morbidity among patients with dermatological diseases generally focuses on outpatients and questionnaire-based surveys. The aim of this study was to determine the prevalence and nature of psychiatric morbidity among dermatological inpatients with diagnosis being made by psychiatric interview, and ascertain whether demographic and clinical details in dermatological inpatients with psychiatric morbidity differed from those without it. METHODS: Charts of all inpatients admitted by the dermatology department between 1 January 1991 and 31 July 1995 were analysed for socio-demographic data, clinical features, treatment and course in hospital. For those patients who were referred to a psychiatrist, all records of the psychiatric consultation were obtained and analysed. RESULTS: A total of 1073 patients were admitted during the study period. Ninety-eight patients (9%) were diagnosed to have a psychiatric illness. Patients with psychiatric illness were likely to have had more admissions and longer duration of hospital stay. The most common psychiatric diagnoses were depressive episodes (34%) and adjustment disorders (29%). The highest rates of psychiatric morbidity were found among patients with chronic urticaria, exfoliative dermatitis and sexually transmitted diseases, including human immunodeficiency virus infection. The prevalence of psychiatric disorders was significantly higher in those who had received long term (more than six weeks) treatment with high-dose steroids (more than 1 mg/kg body weight of prednisolone). CONCLUSION: Some dermatology inpatients have psychiatric morbidity, which affects the course of the dermatological condition as well as the duration of hospitalization. The availability of psychiatric consultation at dermatology clinics and regular liaison between psychiatrists and dermatologists are essential for appropriate management.