Weston et al developed a prognostic score for neonates with acquired cytomegalovirus infection. The study was done at Waikato Hospital in New Zealand.
Parameters:
(1) weeks of gestation
(2) birthweight in grams
(3) percent FIO2 (fraction of inspired oxygen)
(4) mean airway pressure
(5) oral energy intake
(6) chest X-ray
|
Parameter |
Finding |
Points |
|---|---|---|
|
weeks of gestation |
24-25 weeks |
10 |
|
|
26-27 weeks |
8 |
|
|
28-29 weeks |
6 |
|
|
30-33 weeks |
4 |
|
|
34-36 weeks |
2 |
|
|
37-42 weeks |
0 |
|
birthweight in grams |
500-750 grams |
10 |
|
|
751-1,000 grams |
8 |
|
|
1,001-1,250 grams |
6 |
|
|
1,251-1,500 grams |
4 |
|
|
1,501-2,500 grams |
2 |
|
|
> 2,500 grams |
0 |
|
FIO2 in percent |
21% |
0 |
|
|
22-29% |
4 |
|
|
30-39% |
6 |
|
|
40-49% |
8 |
|
|
50-59% |
10 |
|
|
60-69% |
12 |
|
|
70-79% |
14 |
|
|
80-89% |
16 |
|
|
90-99% |
18 |
|
|
100% |
20 |
|
mean airway pressure (MAP) in cm H2O measured at 14 days |
0 |
0 |
|
|
nasopharyngeal CPAP |
3 |
|
|
endotracheal CPAP |
6 |
|
|
< 6 cm water |
10 |
|
|
6 – 9 cm water |
12 |
|
|
10 – 13 cm water |
14 |
|
|
14 – 16 cm water |
16 |
|
|
17 – 19 cm water |
18 |
|
|
> 19 cm water |
20 |
|
oral energy intake |
> 335 J/kg per day |
0 |
|
|
168 – 335 J/kg per day |
2 |
|
|
1 – 167 |
6 |
|
|
0 |
10 |
|
chest X-ray at 14 days |
normal |
0 |
|
|
mild |
3 |
|
|
moderate |
6 |
|
|
severe |
10 |
where:
• The original table gives oral energy intake ranges of 0, 4-167, and 167-335. I modified these to be continuous and nonoverlapping over the range.
grading score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 80
• The higher the score, the greater the neonatal risk.
• Infants who died had grading scores from 38 to 60.
• The authors noted that providing CMV-negative blood to neonates was less expensive than treating the infants who acquired CMV from blood transfusions.
Purpose: To use the prognostic score of Weston et al to evaluate a neonate with an acquired cytomegalovirus (CMV) infection.
Specialty: Infectious Diseases
Objective: severity, prognosis, stage
ICD-10: B25.9,
