Comparison of referral neonatal scores in predicting the risk of death in premature and low birth weight infants

Abstract

Objective To compare the value of three neonatal referal scoring systems in predicting the risk of mortality in preterm and low birth weight infants. Methods Six hundred and fourty-nine premature neonates-fetal age <37 weeks and birth weight <2 500g infants were transported to the neonatal intensive care unit of Hunan Children′s Hospital from January 1 to December 31, 2016.The score of transport risk index of physiologic stability(TRIPS), mortality index for neonatal transportation(MINT)score and transport related mortality score(TREMS)were conducted for them. Results TRIPS, MINT and TREMS scoring systems of the death group were significantly higher than those of the survival group(P<0.001). In the multivariate Logistic regression analysis, systolic blood pressure, reaction of foot hit and the intubation of respiratory in the TRIPS entered the regression equation.The birth weight, blood pH value and whether intubation when contacted in the MINT score were included in the equation.Hypotension, hypoxemia and hypercapnia of TREMS were entered the regression equation, indicating these factors were the independent risk factors for death in preterm and low birth weight infants.The area under the receiver operating characteristic and 95%CI of TRIPS, MINT and TREMS were 0.843(0.796, 0.889), 0.796(0.722, 0.871)and 0.712(0.639, 0.786), respectively. Conclusion The TRIPS is more accurate than MINT and TREMS in predicting the risk of referral mortality in referaling preterm and low birth weight infants. Key words: Preterm and low birth weight infants; Transporting scoring system; Mortality risk assessment; Transport risk index of physiologic stability; Mortality index for neonatal transportation score; Transport related mortality score