Utility of transport risk index of physiological stability score for predicting likely outcome of extramural neonates transferred to NICU


  • Deepali M. Shah Department of Paediatrics, GVR Children Hospital, Kurnool, Andhra Pradesh, India
  • Bhuvaneswari M. Department of Paediatrics, GVR Children Hospital, Kurnool, Andhra Pradesh, India
  • Ramaprasad G. S. Department of Paediatrics, GVR Children Hospital, Kurnool, Andhra Pradesh, India




Neonatal mortality, Transport risk index of physiological stability, Transfer


Background: To accomplish ‘Mission Twenty - Twenty’ and 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 demographic, transport and clinical characteristics of referred neonates and to determine whether TRIPS score serves as predictor of early neonatal mortality i.e. mortality within the first seven days after admission in these babies.

Methods: This cross sectional descriptive study with analytic components was carried out in a tertiary care teaching hospital. All neonates ≥1 kg, born outside of this hospital, and referred here during study period for further management were included. All the data pertaining to clinical, demographic and transport characteristics were recorded. TRIPS score was applied at admission and was related with the final outcome within first seven days of admission; expired or survived. The association between the outcome and TRIPS score was tested using chi square test or fisher’s exact test. ROC curve analysis was done to find out optimum TRIPS score to predict mortality.

Results: Neonatal mortality within first 7 days after admission is related to the TRIPS rating. The score of the survivors and neonatal deaths show a significant difference which is also even reflected by its individual components (p< 0.001). For a score of >18.5, a sensitivity of 89.47% and a specificity of 91.47%; area under the curve of 0.954 was determined.

Conclusions: TRIPS score is a valid predictor of early neonatal mortality. The components of TRIPS score also correlate with early neonatal death. It is important to establish measures to improve physiological stability of the newborn before, during and after the transfer in order to reduce neonatal mortality.


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