Neonatal Mortality Score-9 Mexico of Marquez-Gonzalez et al

Description

Marquez-Gonzalez et al developed a score to predict mortality for a critically-ill neonate. This is based on 9 variables and is referred to as the Neonatal Mortality Score-9 Mexico or EMN-9 Mex. The authors are from multiple neontatal units in Mexico.

Patient selection: critically-ill neonate

Outcome: mortality

Parameters:

(1) Apgar score at 5 minutes

(2) birthweight in grams

(3) blood gases

(4) blood lactate in mmol/L

(5) PaO2 to FIO2 ratio

(6) P(A-a)O2 in mm Hg

(7) a/A ratio (arterial to alveolar oxygen tension ratio, or PaO2/PAO2)

(8) platelet count per µL

(9) serum glucose in mg/dL

Parameter	Finding	Points
Apgar score at 5 minutes	9 or 10	0
	7 or 8	1
	<= 6	2
birthweight in grams	>=2,500 grams	0
	1,500 to 2,499 grams	1
	< 1,500 grams	2
blood gases	normal	0
	metabolic acidosis	1
	metabolic acidosis and anion gap >= 15 mmol/L	2
blood lactate	<= 1 mmol/L	0
	1.1 to 3.9 mmol/L	1
	>= 4.0 mmol/L	2
PaO2 to FIO2 ratio	>= 350 mm Hg	0
	200 to 349 mm Hg	1
	< 200 mm Hg	2
P(A-a)O2	<= 100 mm Hg	0
	101 to 299 mm Hg	1
	>= 300 mm Hg	2
a/A ratio	>= 0.6	0
	0.26 to 0.59	1
	<= 0.25	2
platelet count	>= 150,000 per µL	0
	50,001 to 149,999 per µL	1
	<= 50,000 per µL	2
serum glucose	<= 126 mg/dL	0
	127 to 200 mg/dL	1
	> 200 mg/dL	2

where:

• The paper uses the A/a ratio but the a/A ratio is used in textbooks.

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: 0

• maximum score: 18

• The greater the score the greater the risk for mortality.

Score	Positive Likelihood Ratio
<= 7	0.08
8 to 11	0.21
12 to 15	1.9
16 to 19	10

Performance:

• The area under the ROC curve for a cutoff >= 16 was 0.95.

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Neonatal Mortality Score-9 Mexico of Marquez-Gonzalez et al

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