Annam et al reported the Cord Blood-Hematologic Scoring System (HSS) for identifying a neonate at risk for sepsis. This is based on the Hematologic Scoring System (HSS) of Rodwell et al. The authors are from Mamata Medical College in Telangana, India.
Patient selection: neonate within a few hours of birth
Parameters:
(1) total leukocyte count per µL
(2) mature neutrophils seen
(3) absolute neutrophil count
(4) ratio of immature to total PMN count
(5) immature to mature PMN count
(6) platelet count per microliter
(7) neutrophil morphology (toxic granules, cytoplasmic vacuoles)
(8) micro-ESR in mm in first hour
(9) nucleated red blood cells
Parameter
Finding
Points
total leukocyte count
<= 5,000 per µL
2
>= 25,000 per µL
1
other
0
mature neutrophils
present
0
no mature PMNs seen
2
absolute neutrophil count
1,500 to 8,000 per µL
0
< 1,500 per µL
2
> 8,000 per µL
1
immature to total PMN ratio
<= 0.2
0
> 0.2
1
immature to mature PMN ratio
<= 0.3
0
> 0.3
1
neutrophil morphology
<= 30% of neutrophils
0
> 30% of neutrophils
1
micro ESR
<= 15 mm in first hour
0
> 15 mm in first hour
1
platelet count
> 150,000 per µL
0
<= 150,000 per µL
1
nRBCs
<= 10 per 100 WBC
0
> 10 per 100 WBC
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
Total Score
Risk Group
0 to 3
no sepsis
4 to 6
low
7 to 9
high
10 to 12
septic
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