A Retrospective Cross Sectional Study To Validate Tops Score In Outborn Neonates Referred To Tertiary Care Centre

Abstract

Background-
One of the Sustainable Development Goals aims to reduce neonatal mortality to at least as low as 12 per 1000 live births by 2030. In India, 63% all deaths among children under the age of 5 occurs in the neonatal period, of which 75% deaths occur in their first week of birth. Intrauterine transport to a centre with the necessary resources is considered ideal to deliver a high risk neonate. A further fall in Neonatal Mortality Rate can be achieved by improving Neonatal Transport Facilities with special emphasis on monitoring parameters like temperature, oxygen saturation, skin perfusion, and blood sugar (acronym TOPS) that can significantly affect neonatal physiology and outcome. This retrospective study aims to validate the TOPS score as a predictor of severity and mortality in outborn neonates.
Materials And Methodology - A retrospective diagnostic accuracy cross sectional study was conducted in Department of Paediatrics in a Tertiary care hospital for a duration of 12 months to validate the use of TOPS score to predict severity and outcome in out born neonates referred to Tertiary care hospital.
Results - The present study showed increase in mortality with increase in TOPS score.
A score of ≥2 has got the maximum discrimination for prediction of mortality. The sensitivity, specificity, positive and negative predictive values of derangements of two or more TOPS parameters in predicting mortality were 37.5%, 98.9% 75% and 94.7% respectively.
Conclusion-Our study showed that an increase in the TOPS score correlates with higher mortality, making it an excellent tool for predicting severity and mortality in transported outborn neonates. It is simple, inexpensive, and requires minimal expertise, making it practical for healthcare professionals.