|
Parameter |
Finding |
Points |
|
convulsions |
none |
0 |
|
|
on
anticonvulsive therapy but no seizures |
1 |
|
|
1-5
convulsions per day |
2 |
|
|
frequent motor
convulsions (> 6 per day) |
3 |
|
hydrocephalus |
none |
0 |
|
|
hydrocephalus without
increase in head circumference and good shunt function) |
1 |
|
|
rapid
increase in head size (> 2 cm per week or < 0.5 cm per day) |
2 |
|
|
surgery with shunt
inserted |
3 |
|
|
head
size rises >= 0.5 cm per day |
3 |
|
intracranial
hemorrhage |
none |
0 |
|
|
intracranial hemorrhage
confirmed on CAT scan or ultrasound with some deterioration in
condition |
1 |
|
|
moderate intracranial
hemorrhage with signs such as irritability and head retraction or with
residual signs. Signs may also include decreased hemoglobin, deterioration
in condition, or blood in CSF. |
2 |
|
|
major
intracranial hemorrhage and major symptoms (convulsions, apnea);
hemorrhage confirmed by lumbar puncture, CAT scan or ultrasound |
3 |
|
perinatal
asphyxia |
none |
0 |
|
|
mild
irritability or hypotonia, intubated at birth, but 5 minute Apgar >
5 |
1 |
|
|
neurological
abnormalities (extensor hypertonus, transient myocardial ischemia or moderate acute renal
tubular necrosis) |
2 |
|
|
cardiac arrest or
prolonged attempt at resuscitation at birth or during transfer; severe
neurological signs, apnea or frequent convulsions; 5 minute Apgar score
< 5 |
3 |
|
diarrhea |
none |
0 |
|
|
diarrhea noted and
treated by dietary restriction only |
1 |
|
|
moderate dehydration
requiring IV fluids |
2 |
|
|
severe dehydration from
diarrhea; loss of >= 10% body weight requiring rehydration |
3 |
|
necrotizing
enterocolitis |
none |
0 |
|
|
necrotizing diagnosis on
initial X-ray, or blood in stools and patient put on total parenteral
regimen; colostomy or ileostomy without problems |
1 |
|
|
active necrosis with
marked distention; X-ray changes confirming necrosis; concern about
perforation; ostomy with problems in functioning |
2 |
|
|
perforation or
surgery |
3 |
|
|
very
poor condition |
3 |
|
meningitis |
none |
0 |
|
|
meningitis
well-controlled by antibiotics, with sterile CSF |
1 |
|
|
proven meningitis by
positive blood cultures; condition stable or ventricular reservoir in
place |
2 |
|
|
very
poor condition; shock or convulsions |
3 |
|
sepsis |
none,
or antibiotics given only for suspected infection |
0 |
|
|
mild
infection with positive cultures, or severe infection well controlled with
antibiotics |
1 |
|
|
sepsis confirmed by
positive blood cultures, with elevated WBC and condition fair; if infant's
condition not substantially improved 48 hours after infection
confirmed |
2 |
|
|
very
poor condition with shock and/or DIC; clinical signs of septicemia |
3 |
|
pneumothorax |
none |
0 |
|
|
drain
inserted and functioning normally |
1 |
|
|
pneumothorax with drain
inserted |
2 |
|
|
bilateral
pneumothorax |
3 |
|
|
central cyanosis before
drain |
3 |
|
apnea |
none |
0 |
|
|
requires extra oxygen or
aminophylline |
1 |
|
|
requiring CPAP or
bagging 3 times a day |
2 |
|
|
requires
ventilation |
3 |
|
respiratory distress
syndrome |
none |
0 |
|
|
extra
oxygen requirement |
1 |
|
|
requiring CPAP |
2 |
|
|
requires
ventilation |
3 |
|
chronic lung
disease |
none |
0 |
|
|
extra
oxygen delivery, including oxygen catheter (low flow oxygen) |
1 |
|
|
nasal
oxygen catheter and negative pressure box |
2 |
|
|
confirmed on X-ray,
requiring ventilation |
3 |
|
cardiac failure |
none |
0 |
|
|
requires digoxin (and
diuretics) but condition stable |
1 |
|
|
symptoms requiring Lasix
and responding to indomethacin |
2 |
|
|
intractable failure
requiring vigorous treatment |
3 |
|
hyperbilirubinemia |
none |
0 |
|
|
jaundice requiring
phototherapy (does not include rare jaundice not treated with
phototherapy) |
1 |
|
|
exchange transfusion
required |
2 |
|
hypoglycemia |
none |
0 |
|
|
transient and easily
corrected, < 20 mg/day |
1 |
|
|
requiring persistent
high glucose intravenous infusion of over 10% dextrose solution |
2 |
|
|
severe, producing apnea
or convulsions |
3 |
|
acidosis |
pH
>= 7.20 |
0 |
|
|
pH
from 7.10 - 7.19 |
1 |
|
|
pH
between 7.01 and 7.09 |
2 |
|
|
pH
<= 7.00 |
3 |
|
bleeding tendency |
none |
0 |
|
|
abnormal laboratory
tests (increased PT, increased PTT, thrombocytopenia) |
1 |
|
|
bleeding requiring
transfusion |
2 |
|
|
fulminating disseminated
intravascular coagulopathy (DIC) or pulmonary hemorrhage |
3 |
|
anemia |
none |
0 |
|
|
anemia requiring
"top-up" transfusion |