TOPS score (T-temperature, O-Oxygen saturation, P- Perfusion, S- Sugar) on admission in transported neonates to tertiary care hospital

Abstract

In India, 70% of deliveries take place in rural areas and the transport of the preterm babies to a tertiary care centre are referred only after the birth Babies must be transported to a higher level neonatal intensive care unit (NICU) to overcome the negative effects of critical illness such as respiratory distress and asphyxia in newborns. Most of the neonates are transported without any pre-transport stabilization or care during transport, which can have serious clinical implications on the ultimate outcome of babies. To assess the clinical condition and presence of complications among neonates transported to NICU. To predict outcome of transported neonates in terms of morbidity and mortality based on TOPS score. A cross-sectional observational study was conducted among 500 newborns admitted in NICU, at New Civil Hospital, Surat. Out of total, 258(51.3%) and 245(48.7%) patients were respectively males and females in the study. Out of the 503referred neonates 258 (51.3%) were referred for respiratory distress and ventillatory support, 138(27.4%) were referred for LBW / prematurity. The hypothermia was present post transport approximately among 64% neonates. Hypoglycaemia was found in only 18% of transported neonates. 33% of the studies neonates were hypoxic on reaching the referral centre and the remaining maintained spo2 above 90%.The high sensitivity (81%) and high negative predictive value (87.4%) with a specificity of 61.5% and positive predictive value of 59.7% suggest that TOPS score a very strong screening test to predict the outcome of babies admitted.