Neisseria Sepsis Index (NESI) Score

The Neisseria Sepsis Index (NESI) score can be used to evaluate children with disseminated meningococcal infection.

Parameters:

(1) heart rate

(2) mean arterial pressure

(3) base deficit

(4) new onset of subcutaneous bleeding

Parameter	Finding	Points
heart rate in beats/minute	age <= 3 years, 11 months and heart rate <= 140	0
	age <= 3 years, 11 months and heart rate > 140 and < 200	1
	age <= 3 years, 11 months and heart rate >= 200	2
	age >= 4 years and heart rate <= 120	0
	age >= 4 years and heart rate > 120 and < 180	1
	age >= 4 years and heart rate >= 180	2
mean arterial pressure (MAP) in mm Hg	age <= 3 years, 11 months and MAP >= 45	0
	age <= 3 years, 11 months and MAP > 20 and < 45	1
	age <= 3 years, 11 months and MAP <= 20	2
	age >= 4 years and MAP >= 60	0
	age >= 4 years and MAP > 30 and < 60	1
	age >= 4 years and MAP <= 30	2
base deficit	>= -6 mEq/L	0
	> -12 and < -6	1
	<= -12	2
newly developed subcutaneous bleeding	absent	0
	present	2

where:

• Table 2 from Hachimi-Idrissi et al (page 227) shows age as 3.1when it should be 3 years and 11 months.

• Table 1 in Nurnberger et al has heart rate <= 180 for age >= 4 years; it should be >= 180.

• mean arterial pressure in mm Hg = ((systolic blood pressure) + (2 * (diastolic pressure))) / 3

NESI score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 8

• A score >= 5 indicated severe disease with high risk of morbidity.

To read more or access our algorithms and calculators, please log in or register.

Purpose: To evaluate a child with disseminated meningococcal infection using the Neisseria Sepsis Index (NESI) score.