Maier et al evaluated very low birthweight infants admitted to the neonatal intensive care unit (NICU). They developed a score for predicting risk of mortality based on admission data. The authors are from Humboldt-Uiversitat in Berlin.
Patient selection: very low birthweight infants (below 1,500 grams)
Parameters on admission to NICU:
(1) birthweight in grams
(2) grade of respiratory distress (Giedion et al)
(3) Apgar score at 5 minutes
(4) artificial ventilation
(5) base excess
|
Parameter |
Finding |
Points |
|
birthweight in grams |
1,250 to 1,499 |
3 |
|
|
1,000 to 1,249 |
6 |
|
|
750 to 999 |
9 |
|
|
<= 749 |
12 |
|
grade of respiratory distress |
none (Grade 0) |
0 |
|
|
Grade I |
2 |
|
|
Grade II |
4 |
|
|
Grade III |
6 |
|
|
Grade IV |
8 |
|
Apgar score at 5 minutes |
>= 9 |
0 |
|
|
7 or 8 |
2 |
|
|
5 or 6 |
4 |
|
|
3 or 4 |
6 |
|
|
0 to 2 |
8 |
|
artificial ventilation |
no |
0 |
|
|
yes |
8 |
|
base excess |
>= -2 mmol/L |
0 |
|
|
-2.1 to -5.0 |
1 |
|
|
-5.1 to -8.0 |
2 |
|
|
-8.1 to -10.0 |
3 |
|
|
< -10 |
4 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 3
• maximum score: 40
• The higher the score the greater the risk for mortality.
|
Total Score |
Risk of Mortality |
|
3 to 18 |
low (3%) |
|
19 to 23 |
moderate (27%) |
|
24 to 28 |
high (50-60%%) |
|
29 to 40 |
extreme (80%) |
Specialty: Critical Care, Emergency Medicine, Pedatrics
