Application of Tops Score in Sick Neonates Received At Level 3 Nicu and Its Impact on the Outcome of the Neonate
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Transporting of neonates is the greatest challenge faced today in the outcome of neonates in our country. We have scarce and inaccessible facilities, no any accomplice for enroute and underdeveloped communication system. Many babies thus transported are cold, blue and hypoglycaemic. This study aims to study the applicationof TOPS score and its effect on outcome. Illness severity scores have been used as predictors of neonatal mortality, to give prognostic information to parents about their baby,to identify high risk babies for prompt action (triage) and for standardized comparisons between neonatal units for quality assessment. To evaluatethe TOPS (Temperature,Oxygenation,Perfusion and blood Sugar) score predictive value for hospital death so as to institute an easy tool for assessing mortality index in transported neonates. A prospective study was conducted in a tertiary teaching hospital enrolling 500 transported neonates. TOPS scoring was done at admission (temperature by digital thermometer in axilla, saturation by pulse oximeter, capillary refill time in mid sternum region, blood sugar by reagentstrip) and babies were followed for outcome.A mortality of 29.4% was observed. Derangements in TOPS variables had significant correlation with neonatal mortality. Hypothermia was commonly observed in transported neonates (29.8%).The sensitivity, specificity, positive and negative predictive values of derangements of two or more TOPS parameters in predicting mortality were 67.4%,80.6%,62.2% and 85.4% respectively. Besides being useful to predict hospital death, TOPS was a simple score that can be easily applied in neonatal units.Based on these results, we recommend TOPS score to be done routinely for all the babies at admission.
Authors and Affiliations
Dr Palak T Hapani, Dr Abhishek Berwal, Dr Himanshu Dave
Keywords
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- EP ID EP556209
- DOI 10.9790/0853-1803101115.
- Views 53
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