ICU severity score · Dogs

APPLE-fast illness severity

5-variable Acute Patient Physiologic and Laboratory Evaluation score for hospitalized dogs (Hayes 2010). Glucose, albumin, lactate, platelet count, and mentation produce a 0–50 score that maps to predicted hospital mortality. Externally validated cutoff >25 → specificity 85%, sensitivity 67% for mortality (Le Gal 2021).

Have the full lab block (chem panel, CBC, blood gas, FAST/TFAST)? The 10-variable APPLE-full score delivers better discrimination (AUROC 0.93 vs 0.87).

Units

SI (mmol/L, g/L) US (mg/dL, g/dL)

Laboratory values

Use the most abnormal value in the first 24 h after admission. Leave at 0 to skip.

Glucose (mmol/L)

Albumin (g/L)

Lactate (mmol/L)

Platelet count (×10⁹/L or K/µL)

Mentation

Assessed at admission, before sedation or analgesia.

0. Normal 1. Able to stand unassisted, responsive but dull 2. Can stand only when assisted, responsive but dull 3. Unable to stand, responsive 4. Unable to stand, unresponsive

Scoring notes — counterintuitive items

Three scoring quirks Hayes 2010 explicitly flags. They are preserved here exactly as published. The multivariable regression captures the mortality risk not already explained by the other variables, so individual bands need not look clinically intuitive.

Glucose >15 mmol/L (>273 mg/dL) → 0 pts. Referent group in the original cohort; dominated by treated diabetics + transient stress hyperglycemia, which carried lowest mortality in that population.
Platelets 151–200 → 6 pts (higher than <151 → 5 pts). Artifact of the multivariable model captured at publication and retained here verbatim.
Albumin >35 g/L (>3.5 g/dL) → 2 pts. After adjusting for the other variables, high albumin tracked with slightly increased mortality risk.

Awaiting input

Enter glucose, albumin, lactate, platelet count, and the mentation score to compute the APPLE-fast score.