Thompson Scoring in HIE : Severity and Prognostic grading

Thompson score is based on features of HIE with a maximum possible score of 22. A score of 15 or more has shown a positive predictive value of 92%, negative predictive value of 82%, sensitivity of 71% and specificity of 96% for abnormal outcome at 12 months of age.

Thompson score for HIE       

Score Sign	0	1	2	3
Tone	Normal	Hyper	Hypo	Flaccid
LOC	Normal	Hyperalert, stare	Lethargic	Comatose
Fits	None	< 3/day	>2/day
Posture	Normal	Fisting, cycling	Strong distal flexion	Decerebrate
Moro	Normal	Partial	Absent
Grasp	Normal	Poor	Absent
Suck	Normal	Poor	Absent ± bites
Respiration	Normal	Hyperventilation	Brief apnea	IPPV (apnea)
Fontanelle	Normal	Full, not tense	Tense

Recording

Date
Time
Tone
LOC
Fits
Posture
Moro
Grasp
Suck
Respir
Fontanell
TOTAL

Maximum Score = 22

Interpretation:

1. 1–10: mild HIE
2. 11–14: moderate HIE
3. 15–22: severe HIE

Source: Thompson CM, Puterman AS, Linley LL, Hann FM, van der Elst CW, Molteno CD, Malan AF. The value of a scoring system for hypoxic ischaemic encepha­lopathy in predicting neurodevelopmental outcome. Acta Paediatr 1997; 86: 757-61

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