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Although the APACHE II total score is the most widely used ICU mortality prediction score, it has a number of limitations and shortcomings. The total score is not intended to be applied to specific populations such as liver failure or HIV subjects and is not accurate when dealing with subjects transferred from another unit or another hospital. This is known as lead time bias and is addressed in  APACHE III.

Jira
showSummary false server Issue Tracker (JIRA) serverId 85506ce4-3cb3-3d91-85ee-f633aaaf4a45 key ADQRS-326

The APACHE II total score must be recalibrated before it can be used in a population other than the general ICU population.

Jira
showSummary false server Issue Tracker (JIRA) serverId 85506ce4-3cb3-3d91-85ee-f633aaaf4a45 key ADQRS-327

 ICU prediction scores in general need to be periodically recalibrated to reflect changes and improvements in practice and subject demographics. Be sure to discuss the use of this instrument with the appropriate regulatory authorities.

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