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%.
Specialty: Critical Care, Emergency Medicine, Pedatrics