Correlation of TOPS scoring with immediate outcome among neonates transported to special newborn care unit: a prospective study

Gargi H. Pathak, Anuya V. Chauhan, Priyanka B. Patel


Background: Several sick neonates require transfer to tertiary level care neonatal unit for treatment. The facilities of neonatal transport in India are not optimal and the newborn thus transported can become hypothermic, hypoxic and/or hypoglycemic which can affect the neonatal outcome. These parameters can be maintained during transport by adopting simple measures. The aim and objective of this study is to study impact of acute physiological parameters during transfer of neonates on their immediate outcome by using TOPS score. TOPS score - Temperature, Oxygenation, Perfusion (Assessed by capillary refill time), Blood sugar.

Methods: This prospective observational study was conducted at the special newborn care unit, Civil Hospital, Ahmedabad enrolling 460 transported neonates. TOPS scoring for each neonate was done at admission, and then the parameters of the TOPS score were correlated with the outcome at 48 h of admission.

Results: A total of 460 transported newborns were assessed, 47.8% newborns were hypothermic, 33.9% had poor perfusion, 27.8% were hypoxemic, and 22% were hypoglycemic. On correlating with the outcome, Hypoxemia and hypo perfusion had the highest sensitivity (92.2% and 57.3%, respectively) while hypoglycemia had the highest specificity (88%), for an adverse outcome.

Conclusions: TOPS score is a useful and easy to use the method to assess the physiological status and predict early mortality in transported neonates.


Mortality neonatal transport, Outcome, Oxygenation, Perfusion and Blood sugar, TOPS score, Temperature

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