Neonates are at risk for vascular insufficiency in a limb, which can result in gangrene and the need for amputation. Infants in the neonatal ICU are at greatest risk. Letts et al developed a simple risk score that can help identify neonates at risk for this complication.
Parameters:
(1) prematurity
(2) umbilical artery catheter
(3) polycythemia
(4) maternal diabetes
(5) twin (probably also multiple gestation)
(6) septicemia
Parameter
Finding
Points
prematurity
no
0
yes
3
umbilical artery catheter
no
0
yes
3
polycythemia
hemoglobin <= 20 g/dL
0
hemoglobin > 20 g/dL
3
maternal diabetes
no
0
yes
2
twin or other multiple gestation
no
0
yes
2
septicemia
no
0
yes
2
where:
• Twins or other forms of multiple gestation are often delivered premature.
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the greater the risk for vascular insufficiency.
• A score >= 10 indicates a high risk of vascular insult.
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