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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)
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Disease relevance of APACHE

  • METHODS: Glasgow score, Apache II, computed tomography (CT) scan score, C reactive protein (CRP), serum IgM antiendotoxin antibodies (EndoCAb), and total antioxidant capacity (TAC) were determined on admission in 34 patients with acute pancreatitis [1].
  • OBJECTIVE--In this article we determine the incidence and clinical spectrum of invasive pneumococcal disease in the White Mountain Apache population, a group known to have a high incidence of invasive disease due to Haemophilus influenzae type b [2].
  • The C krusei cases were compared with 57 cases of C albicans fungemia with respect to demographics, underlying cancer, Acute Physiology and Chronic Health Evaluation II score, immunosuppression status, chemotherapy, and the use of central venous catheters, as well as fluconazole prophylaxis [3].
  • Therefore, APACHE II scores and either IL-6 or IL-10 concentration may be the most reliable parameters for stratification of patients in future studies of severe gram-negative sepsis [4].
  • PRP-OMP (Hib capsular polysaccharide linked to the outer membrane protein complex of Neisseria meningitidis) produced good immune responses in 2-month-old Navajo and Apache infants after a single dose [5].

High impact information on APACHE

  • Twenty-three of the 37 patients (62 percent) in the group undergoing dialysis with the polymethyl methacrylate membrane recovered renal function, as compared with 13 of the 35 patients (37 percent) in the group undergoing dialysis with the cuprophane membrane (P = 0.04 after adjustment for the APACHE II score) [6].
  • The concentrations of H. influenzae type b antibody after immunization with polysaccharide vaccine were approximately 10-fold lower in 24-month-old Apache children than in whites of a similar age (P less than 0.01) [7].
  • PATIENTS--A total of 362 admissions for COPD exacerbation selected from the Acute Physiology and Chronic Health Evaluation (APACHE) III database of 17,440 ICU admissions [8].
  • Univariate analysis showed older age, higher APACHE II score, nosocomial acquisition, recent surgical procedure, total parenteral nutrition, and antibiotic treatment to be significantly associated with the acquisition of beta-lactamase-producing, high-level gentamicin-resistant E. faecalis [9].
  • The risk for infection or colonization with beta-lactamase-producing, high-level gentamicin-resistant E. faecalis was strongly associated with severe underlying disease (acute physiology and chronic health evaluation [APACHE] II score, greater than 6) and previous antibiotic treatment [9].

Chemical compound and disease context of APACHE


Biological context of APACHE


Anatomical context of APACHE


Associations of APACHE with chemical compounds

  • In septic patients elevated plasma concentrations of endothelin-1 were inversely correlated with cardiac index (r = -0.80, p less than 0.005) and positively correlated the severity of illness as documented by APACHE II score (r = 0.74, p less than 0.01) and plasma creatinine levels (r = 0.80, p less than 0.005) [25].
  • However, patients who received ceftazidime were more severely ill than those who received ciprofloxacin on the basis of APACHE II scores [26].
  • After adjusting for potentially confounding effects of the Acute Physiology and Chronic Health Evaluation (APACHE) III score, days to first dose, and fungal colonization at enrollment, the risk of fungal infection was reduced by 55% in the fluconazole group [27].
  • Nitrite excretion correlated strongly with both intestinal permeability (r=0.7, p=0.006) and EndoCAb ratio (r=0.7, p<0.01) but not with CRP or APACHE-II scores (p>0.1) [28].
  • Similarly, antipyrine and lorazepam clearances were significantly correlated with injury severity based on the Acute Physiologic and Chronic Health Evaluation (APACHE II) score (r = -0.43 and r = -0.37, respectively) [29].

Gene context of APACHE

  • IL-8 levels after 2 h of reperfusion correlated with lung function assessed by the Pa(O2 )/FI(O(2)) ratio, the mean airway pressure, and the APACHE score during the first 24 postoperative hours [30].
  • The logarithm of the initial plasma levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-1 receptor antagonist (ra), and plasminogen activator inhibitor (PAI)-1 correlated significantly with APACHE II scores (r2 = .67, .57, .68, .81, and .68, respectively) [31].
  • Although baseline APACHE II score was similar in both high-risk subgroups, soluble TNF receptor-p55 concentrations were significantly higher in subgroup C compared with subgroup B already at baseline (10.7 vs. 4.7 ng/mL) [32].
  • Likewise, the overall severity of disease as indicated by Acute Physiology and Chronic Health Evaluation III scores was higher in this group (98 +/- 30) than in the group without detectable MMP-1 or MMP-3 (78 +/- 28) [33].
  • IL-8 (OR = 8.25, CI = 1.03-65.9) and APACHE II scores (OR = 12.6, CI = 2.24-70.4) were found to be significantly better predictive factors of mortality (P < 0.01) than IL-6 (OR = 3.60, CI = 0.57-22.7), TNF (OR = 0.24, CI = 0.01-11.0) and age (OR = 1.02, CI = 0.98-1.06) [34].

Analytical, diagnostic and therapeutic context of APACHE


  1. Compared with parenteral nutrition, enteral feeding attenuates the acute phase response and improves disease severity in acute pancreatitis. Windsor, A.C., Kanwar, S., Li, A.G., Barnes, E., Guthrie, J.A., Spark, J.I., Welsh, F., Guillou, P.J., Reynolds, J.V. Gut (1998) [Pubmed]
  2. High incidence rates of invasive pneumococcal disease in the White Mountain Apache population. Cortese, M.M., Wolff, M., Almeido-Hill, J., Reid, R., Ketcham, J., Santosham, M. Arch. Intern. Med. (1992) [Pubmed]
  3. Candida krusei fungemia. An escalating serious infection in immunocompromised patients. Abbas, J., Bodey, G.P., Hanna, H.A., Mardani, M., Girgawy, E., Abi-Said, D., Whimbey, E., Hachem, R., Raad, I. Arch. Intern. Med. (2000) [Pubmed]
  4. Prognostic value of cytokine concentrations (tumor necrosis factor-alpha, interleukin-6, and interleukin-10) and clinical parameters in severe melioidosis. Simpson, A.J., Smith, M.D., Weverling, G.J., Suputtamongkol, Y., Angus, B.J., Chaowagul, W., White, N.J., van Deventer, S.J., Prins, J.M. J. Infect. Dis. (2000) [Pubmed]
  5. Prevention of Haemophilus influenzae type b infections in Apache and Navajo children. Santosham, M., Rivin, B., Wolff, M., Reid, R., Newcomer, W., Letson, G.W., Almeido-Hill, J., Thompson, C., Siber, G.R. J. Infect. Dis. (1992) [Pubmed]
  6. Effect of the dialysis membrane in the treatment of patients with acute renal failure. Hakim, R.M., Wingard, R.L., Parker, R.A. N. Engl. J. Med. (1994) [Pubmed]
  7. Impaired antibody response to Haemophilus influenzae type b polysaccharide and low IgG2 and IgG4 concentrations in Apache children. Siber, G.R., Santosham, M., Reid, G.R., Thompson, C., Almeido-Hill, J., Morell, A., deLange, G., Ketcham, J.K., Callahan, E.H. N. Engl. J. Med. (1990) [Pubmed]
  8. Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease. Seneff, M.G., Wagner, D.P., Wagner, R.P., Zimmerman, J.E., Knaus, W.A. JAMA (1995) [Pubmed]
  9. Infections due to beta-lactamase-producing, high-level gentamicin-resistant Enterococcus faecalis. Wells, V.D., Wong, E.S., Murray, B.E., Coudron, P.E., Williams, D.S., Markowitz, S.M. Ann. Intern. Med. (1992) [Pubmed]
  10. Procalcitonin in fever of unknown origin after liver transplantation: a variable to differentiate acute rejection from infection. Kuse, E.R., Langefeld, I., Jaeger, K., Külpmann, W.R. Crit. Care Med. (2000) [Pubmed]
  11. N-acetyl-L-cysteine depresses cardiac performance in patients with septic shock. Peake, S.L., Moran, J.L., Leppard, P.I. Crit. Care Med. (1996) [Pubmed]
  12. Risk factors for the development of polyneuropathy and myopathy in critically ill patients. de Letter, M.A., Schmitz, P.I., Visser, L.H., Verheul, F.A., Schellens, R.L., Op de Coul, D.A., van der Meché, F.G. Crit. Care Med. (2001) [Pubmed]
  13. Carriage of methicillin-resistant Staphylococcus aureus, ceftazidime-resistant Gram-negative bacilli, and vancomycin-resistant enterococci before and after intensive care unit admission. Ho, P.L. Crit. Care Med. (2003) [Pubmed]
  14. Intestinal permeability after severe trauma and hemorrhagic shock is increased without relation to septic complications. Roumen, R.M., Hendriks, T., Wevers, R.A., Goris, J.A. Archives of surgery (Chicago, Ill. : 1960) (1993) [Pubmed]
  15. Predicting patient outcome from acute renal failure comparing three general severity of illness scoring systems. Fiaccadori, E., Maggiore, U., Lombardi, M., Leonardi, S., Rotelli, C., Borghetti, A. Kidney Int. (2000) [Pubmed]
  16. Severe community-acquired pneumonia as a cause of severe sepsis: data from the PROWESS study. Laterre, P.F., Garber, G., Levy, H., Wunderink, R., Kinasewitz, G.T., Sollet, J.P., Maki, D.G., Bates, B., Yan, S.C., Dhainaut, J.F. Crit. Care Med. (2005) [Pubmed]
  17. Predictive value of antithrombin III and serum C-reactive protein concentration in critically ill patients with suspected sepsis. Pettilä, V., Pentti, J., Pettilä, M., Takkunen, O., Jousela, I. Crit. Care Med. (2002) [Pubmed]
  18. The clinical value of procalcitonin in early assessment of acute pancreatitis. Modrau, I.S., Floyd, A.K., Thorlacius-Ussing, O. Am. J. Gastroenterol. (2005) [Pubmed]
  19. Effects of a heat and moisture exchanger and a heated humidifier on respiratory mucus in patients undergoing mechanical ventilation. Nakagawa, N.K., Macchione, M., Petrolino, H.M., Guimarães, E.T., King, M., Saldiva, P.H., Lorenzi-Filho, G. Crit. Care Med. (2000) [Pubmed]
  20. Haemodialysis-membrane biocompatibility and mortality of patients with dialysis-dependent acute renal failure: a prospective randomised multicentre trial. International Multicentre Study Group. Jörres, A., Gahl, G.M., Dobis, C., Polenakovic, M.H., Cakalaroski, K., Rutkowski, B., Kisielnicka, E., Krieter, D.H., Rumpf, K.W., Guenther, C., Gaus, W., Hoegel, J. Lancet (1999) [Pubmed]
  21. Risk factors for renal dysfunction in the postoperative course of liver transplant. Lebrón Gallardo, M., Herrera Gutierrez, M.E., Seller Pérez, G., Curiel Balsera, E., Fernández Ortega, J.F., Quesada García, G. Liver Transpl. (2004) [Pubmed]
  22. Outcome of patients with acute myeloid leukemia and pulmonary infiltrates requiring invasive mechanical ventilation-a retrospective analysis. Rabe, C., Mey, U., Paashaus, M., Musch, A., Tasci, S., Glasmacher, A., Schmidt-Wolf, I.G., Sauerbruch, T., Dumoulin, F.L. Journal of critical care. (2004) [Pubmed]
  23. Recombinant human granulocyte colony-stimulating factor attenuates inflammatory responses in septic patients with neutropenia. Ishikawa, K., Tanaka, H., Matsuoka, T., Shimazu, T., Yoshioka, T., Sugimoto, H. The Journal of trauma. (1998) [Pubmed]
  24. Eustachian tube function in an American Indian population. Beery, Q.C., Doyle, W.J., Cantekin, E.I., Bluestone, C.D., Wiet, R.J. The Annals of otology, rhinology & laryngology. Supplement. (1980) [Pubmed]
  25. Elevated plasma endothelin-1 concentrations are associated with the severity of illness in patients with sepsis. Pittet, J.F., Morel, D.R., Hemsen, A., Gunning, K., Lacroix, J.S., Suter, P.M., Lundberg, J.M. Ann. Surg. (1991) [Pubmed]
  26. Randomized study of intravenous/oral ciprofloxacin versus ceftazidime in the treatment of hospital and nursing home patients with lower respiratory tract infections. Trenholme, G.M., Schmitt, B.A., Spear, J., Gvazdinskas, L.C., Levin, S. Am. J. Med. (1989) [Pubmed]
  27. Double-blind placebo-controlled trial of fluconazole to prevent candidal infections in critically ill surgical patients. Pelz, R.K., Hendrix, C.W., Swoboda, S.M., Diener-West, M., Merz, W.G., Hammond, J., Lipsett, P.A. Ann. Surg. (2001) [Pubmed]
  28. Increased nitric oxide excretion in patients with severe acute pancreatitis: evidence of an endotoxin mediated inflammatory response? Rahman, S.H., Ammori, B.J., Larvin, M., McMahon, M.J. Gut (2003) [Pubmed]
  29. Effect of neurotrauma on hepatic drug clearance. Boucher, B.A., Kuhl, D.A., Fabian, T.C., Robertson, J.T. Clin. Pharmacol. Ther. (1991) [Pubmed]
  30. Interleukin-8 release during early reperfusion predicts graft function in human lung transplantation. De Perrot, M., Sekine, Y., Fischer, S., Waddell, T.K., McRae, K., Liu, M., Wigle, D.A., Keshavjee, S. Am. J. Respir. Crit. Care Med. (2002) [Pubmed]
  31. Plasma levels of cytokines in primary septic shock in humans: correlation with disease severity. Gårdlund, B., Sjölin, J., Nilsson, A., Roll, M., Wickerts, C.J., Wretlind, B. J. Infect. Dis. (1995) [Pubmed]
  32. Early prediction of outcome in score-identified, postcardiac surgical patients at high risk for sepsis, using soluble tumor necrosis factor receptor-p55 concentrations. Pilz, G., Fraunberger, P., Appel, R., Kreuzer, E., Werdan, K., Walli, A., Seidel, D. Crit. Care Med. (1996) [Pubmed]
  33. Matrix metalloproteinases and matrix metalloproteinase inhibitors in acute lung injury. Fligiel, S.E., Standiford, T., Fligiel, H.M., Tashkin, D., Strieter, R.M., Warner, R.L., Johnson, K.J., Varani, J. Hum. Pathol. (2006) [Pubmed]
  34. Interleukin-8 as a predictor of the severity of bacteremia and infectious disease. Lin, K.J., Lin, J., Hanasawa, K., Tani, T., Kodama, M. Shock (2000) [Pubmed]
  35. The principle of parsimony: Glasgow Coma Scale score predicts mortality as well as the APACHE II score for stroke patients. Weingarten, S., Bolus, R., Riedinger, M.S., Maldonado, L., Stein, S., Ellrodt, A.G. Stroke (1990) [Pubmed]
  36. Pulmonary infiltrates in liver transplant recipients in the intensive care unit. Singh, N., Gayowski, T., Wagener, M.M., Marino, I.R. Transplantation (1999) [Pubmed]
  37. Influence of long-term continuous intravenous administration of pentoxifylline on endothelial-related coagulation in critically ill patients. Boldt, J., Müller, M., Heyn, S., Welters, I., Hempelmann, G. Crit. Care Med. (1996) [Pubmed]
  38. Prospective, randomized, controlled trial to determine the effect of early enhanced enteral nutrition on clinical outcome in mechanically ventilated patients suffering head injury. Taylor, S.J., Fettes, S.B., Jewkes, C., Nelson, R.J. Crit. Care Med. (1999) [Pubmed]
  39. Prognostic usefulness of scoring systems in critically ill patients with severe acute pancreatitis. Williams, M., Simms, H.H. Crit. Care Med. (1999) [Pubmed]
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