Status of Transported Neonates and Evaluation of TOPS as a Survival Score
Journal Title: Indian Journal of Neonatal Medicine and Research - Year 2017, Vol 5, Issue 2
Abstract
Introduction: To achieve sustainable development goal -3, now we need to focus our attention more towards neonates being transported to higher centre in this very fragile period. We planned this study to assess clinical and demographic characteristics of referred neonates and to evaluate TOPS as a survival score in these babies. Aim: To study the morbidity and mortality pattern in out born neonates admitted in Umaid Hospital. To evaluate TOPS score to predict their outcome. Materials and Methods: This prospective observational study was carried out in a tertiary care teaching hospital. All neonates ≥ 1 kg, born outside of this hospital, and referred here for further management were included. All the data pertaining to clinical and demographic characteristics were recorded. TOPS score was applied at admission and was related with the final outcome; expired or survived. Outcomes were analyzed using chi square test, and ROC curve analysis was done to find out optimum TOPS score to predict mortality. Results: Seventy percent of neonates were referred via ambulance, but condition of these babies at admission was dismal; hypothermic (46.67%), hypoxic (39.23%), hypoglycaemic (21.28%), and poor perfusion (14.61%), the last group being the most fatal (63.16% mortality). TOPS score of ≥2 with AUC of 0.83 proved to be accurate in predicting mortality among these neonates. Conclusion: Though, condition of neonatal transport is gradually improving in the country, it needs further acceleration for desirable reductions in neonatal mortality. TOPS is a valid survival score.
Authors and Affiliations
Dr. Suresh Kumar Verma, Dr. Chandra Prakash Nagaura, Dr. Vishnu Kumar Goyal, Dr. Kapil Kumar Raheja, Dr. Anurag Singh, Dr. Pramod Sharma, Dr. Rama Kishan Bishnoi, Dr. Kirti Sachdev
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