Hayes G, Mathews K, Doig G, et al. The feline acute patient physiologic and laboratory evaluation (Feline APPLE) score: a severity of illness stratification system for hospitalized cats. J Vet Intern Med 2011;25:26-38.
This study’s objective was to construct and validate an accurate, user-friendly score to stratify illness severity or mortality risk prediction in hospitalized cats. This was an observational cohort study of 600 cats admitted to a teaching hospital’s intensive care unit. Diagnosis-independent illness severity scores are available for humans, dogs, and horses. No such scores are available for cats. Two important points must be considered in regards to score use. First, the scores have been constructed and validated on patient data obtained over the initial 24 hours after hospital admission, for patients requiring IV support or close monitoring. Second, the scores are designed to risk stratify populations, not to prognosticate individual patients. Use of scores to stratify patients to facilitate protocols, i.e. treatment regimen establishment, is acceptable. Use of scores for withdrawal of care protocols is contraindicated. The study found that an 8-variable model showed better predictive performance than a 5-variable model, and would be the optimal model to use when possible. The 8-variable model includes mentation score, temperature, mean arterial pressure, lactate, PCV, urea, chloride, and body cavity fluid score. The 5-variable score, i.e. mentation score, temperature, mean arterial pressure, lactate, and PCV, requires only “bench top” or clinical variables that may be more accessible in some circumstances. Therefore, 2 scoring systems have been developed that offer a robust measure of illness severity and facilitate objectification of illness severity in clinical research. [VT]
Hayes G, Mathews K, Doig G, et al. The acute patient physiologic and laboratory evaluation (APPLE) score: a severity of illness stratification system for hospitalized dogs. J Vet Intern Med 2010;24:1034-1047.