Description

Cetinkaya et al modified the NEOMOD score for premature infant. This can help to identify a patient with multiple organ failures who may benefit from more aggressive or novel therapy. The authors are from Uludag University in Bursa, Turkey.


 

The original NEOMOD scoring system has 7 items:

(1) CNS imaging

(2) platelet count

(3) breathing/respirations

(4) gastrointestinal tract and nutrition

(5) blood pressure

(6) urine output

(7) base deficit

 

The modified system added another 7 items:

(1) white blood cell count

(2) serum total bilirubin

(3) serum ALT

(4) heart rate

(5) serum creatinine

(6) peripheral edema

(7) serum albumin

Parameter

Finding

Points

CNS imaging

intraparenchymal hemorrhage, hydrocephalus, atrophy, leukomalacia

2

 

intraventricular hemorrhage

1

 

no hemorrhage or only hemorrhage into the subependymal germinal matrix

0

platelet count

< 30,000 per µL

2

 

30,000 to 100,000 per µL

1

 

> 100,000 per µL

0

breathing/respirations

mechanical ventilation

2

 

continuous positive airway pressure or supplemental oxygen

1

 

spontaneous respirations

0

GI tract/nutrition

necrotizing enterocolitis

2

 

total parenteral nutrition

1

 

enteral feeding

0

blood pressure

hypotension despite pharmaceutical support

2

 

continuous pharmaceutical suppoirt

1

 

adequate

0

base deficit

> 15 mEq/L

2

 

7 to 15 mEq/L

1

 

< 7 mEQ/L

0

urine output

< 0.2 mL per kg per hour

2

 

0.2 to 1 mL per kg per hour

1

 

> 1 mL per kg per hour

0

white blood cell count

< 3,000 per µL

2

 

3,000 to 5,000 per µL

1

 

> 5,000 per µL

0

serum total bilirubin

> 6 mg/dL

2

 

4 to 6 mg/dL

1

 

< 4 mg/dL

0

serum ALT

>= 2 times ULN

2

 

> ULN and < 2 ULN

1

 

<= ULN

0

heart rate

> 180 per minute

2

 

< 100 per minute

2

 

100 to 180 per minute

0

serum creatinine

> 2 mg/dL

2

 

1 to 2 mg/dL

1

 

< 1 mg/dL

0

peripheral edema

generalized

2

 

subcutaneous

1

 

none

0

serum albumin

< 2.5 g/dL

2

 

2.5 to 3.0 g/dL

1

 

> 3 g/dL

0

 

total score =

= SUM(points for all 14 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 28

• A score >= 7.5 was associated with increased 28-day mortality (78%).

 

Performance:

• The sensitivity was 84% and specificity 78%.

 


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