Kocherlakota reported the NASCORE for evaluating a neonate for abstinence. The authors are from Montefiore St. Luke's Cornwall Hospital and Maria Ferrari Children's Hospital at Westchester Medical Center in New York.
Patient selection: neonate
Parameters:
(1) neural tone (when not crying)
(2) agitation tremors
(3) seizures
(4) sleeping
(5) crying
(6) oral feedings
(7) respirations
(8) axillary temperature in °C
(9) stools
|
Parameter |
Finding |
Points |
|
neural tone |
relaxed |
0 |
|
|
mild hypertonia |
1 |
|
|
moderate hypertonia |
2 |
|
|
hyperactive moro |
3 |
|
agitation tremors |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
seizures |
none |
0 |
|
|
nonspecific movements |
1 |
|
|
myoclonic jerks |
2 |
|
|
seizures |
3 |
|
sleeping |
3 hours or more |
0 |
|
|
poor sleeper |
1 |
|
|
difficult sleeper |
2 |
|
|
non-sleeper |
3 |
|
crying |
easily distracted or consolable |
0 |
|
|
irritable |
1 |
|
|
high-pitched |
2 |
|
|
continuous |
3 |
|
oral feedings |
full |
0 |
|
|
difficult feeder |
1 |
|
|
poor feeder |
2 |
|
|
terrible feeder |
3 |
|
respirations |
< 60 per minute and no retractions |
0 |
|
|
60 t0 80 per minute and no retraction |
1 |
|
|
80 to 100 per minute and no retractions |
2 |
|
|
> 100 per minute and no retractions |
3 |
|
|
retractions |
3 |
|
axillary temperature |
36.5 to 37.4° |
0 |
|
|
37.5Kocherlako to 38.3°C |
1 |
|
|
> 38.4°C |
2 |
|
|
> 38.4°C with sweating |
3 |
|
stools |
normal |
0 |
|
|
loose |
1 |
|
|
loose and frequent (more than 1 per 3 hours) |
2 |
|
|
watery and explosive |
3 |
where:
• A score < 36.5 does not have a score.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 27
• A score >= 4 is associated with neonatal abstincence syndrome.
Performance:
• The reported sensitivity is 100% and specificity of 96%.
Specialty: Pharmacology, clinical
