The Japan Society of Obstetrical, Gynecological and Neonatal Hematology (JSOGNH) reported a score for disseminated intravascular coagulation (DIC) in a neonate. These can help to identify a patient who may require more aggressive management.
Patient selection: neonate
Parameters:
(1) birthweight in grams
(2) platelet count per microliter
(3) platelet count 24 hours prior
(4) plasma fibrinogen in mg/dL
(5) INR
(6) FDP or D-dimer
(7) upper limit of reference range (ULN) for FDP or D-Dimer
(8) myelosuppression
(9) underlying condition infection
reduction in platelet count in percent =
= ((count 24 hours ago) - (current count)) / (count 24 hours ago) * 100%
FDP or D-Dimer as multiple of ULN =
= (level) / (ULN)
|
Parameter
|
Finding
|
Points
|
|
platelet count
|
>= 70,000 per µL AND reduction < 50%
|
0
|
|
|
>= 70,000 per µL AND reduction >= 50% AND reduction due to myelosuppression
|
0
|
|
|
>= 70,000 per µL AND reduction >= 50% AND reduction NOT due to myelosuppression
|
1
|
|
|
50,000 to 69,999 per µL
|
1
|
|
|
< 50,000 per µL
|
2
|
|
FDP or D-Dimer
|
< 2.5 times ULN
|
-1
|
|
|
2.5 to 9.99 times ULN
|
1
|
|
|
>= 10 * ULN
|
2
|
|
fibrinogen
|
>= 100 mg/dL
|
0
|
|
|
50 to 99.8 mg/dL AND weight < 1500 g
|
0
|
|
|
50 to 99.8 mg/dL AND weight >= 1500 g
|
1
|
|
|
< 50 mg/dL AND weight < 1500 g
|
1
|
|
|
< 50 mg/dL AND weight >= 1500
|
2
|
|
INR
|
< 1.6
|
0
|
|
|
1.6 to 1.79 AND weight < 1500 grams
|
0
|
|
|
1.6 to 1.79 AND weight >= 1500 grams
|
1
|
|
|
>= 1.8 AND weight < 1500 grams
|
1
|
|
|
>= 1.8 AND weight >= 1500 grams
|
2
|
total score =
= SUM(points for all of the parameters) + (1 point if underlying disease is an infection)
Interpretation:
• minimum score: -1
• maximum score if < 1500 grams: 7
• maximum score if >= 1500 grams: 9
