Mansoor et al modified the Sick Neonate Score (SNS) of Rathod et al for a resource-limited setting. This can help to identify a neonate who may require more aggressive management. The authors are from Kasturba Medical College in Mangalore, India.
Patient selection: sick neonate with axillary temperature < 37.5°C
Differences from SNS: removal of mean blood pressure; addition of gestational age and birth weight
Parameters:
(1) respiratory effort
(2) heart rate
(3) axillary temperature in °C
(4) capillary refilling time in seconds
(5) random blood glucose in mg/dL
(6) SpO2 in percent on room air
(7) gestational age in weeks
(8) birth weight in kilograms
|
Parameter
|
Finding
|
Points
|
|
respiratory effort
|
apnea or grunt
|
0
|
|
|
> 60 bpm (tachypnea)
|
1
|
|
|
40 to 60 bpm
|
2
|
|
heart rate
|
bradycardia or asystole
|
0
|
|
|
> 160 bpm (tachycardia)
|
1
|
|
|
100 to 160 bpm
|
2
|
|
axillary temperature
|
< 36°C
|
0
|
|
|
36 to 36.5°C
|
1
|
|
|
36.6 to 37.5°C
|
2
|
|
capillary refill time
|
> 5 seconds
|
0
|
|
|
3 to 5 second
|
1
|
|
|
< 3 seconds
|
2
|
|
random blood glucose
|
< 40 mg/dL
|
0
|
|
|
40 to 60 mg/dL
|
1
|
|
|
> 60 mg/dL
|
2
|
|
SpO2 on room air
|
< 85%
|
0
|
|
|
85 to 92%
|
1
|
|
|
> 92%
|
2
|
|
gestational age
|
< 32 weeks
|
0
|
|
|
32 to 36+6/7 days
|
1
|
|
|
>= 37 weeks
|
2
|
|
birth weight
|
> 1. 5kg
|
0
|
|
|
1.5 to 2.49 kg
|
1
|
|
|
>= 2.5 kg
|
2
|
where:
• A respiratory rate less than 40 breaths per minute will be assigned 0 points.
• Tachypnea may be with or without retractions.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• A score <= 10 has a good sensitivity and specificity for predicting mortality.
Performance:
• The area under the ROC curve is 0.91.
