Critical Neonatal Score To Assess Illness Severity Of Transport Neonates

Objective:To evaluate the performance of the Transport Risk Index ofPhysiologic Stability (TRIPS), Score for Neonatal Acute Physiology,Version Ⅱ (SANP-Ⅱ) and Score for Neonatal Acute Physiology-PerinatalExtension, Version Ⅱ (SNAPPE-Ⅱ) for severity of transported neonates.Method:The study enrolled the neonates transported to our department duringJan.1to Dec.31of2012. The clinical data were collected and analyzedretrospectively to compare the prediction accuracy of7-day mortality,severe (≥Grade Ⅲ) intra-ventricular hemorrhage (IVH) and mechanicalventilation (MV).Result:475neonates were enrolled. Hosmer-Lemeshow goodness-of-fit testshowed good calibration of the TRIPS (P=0.73), SANP-Ⅱ (P=0.30) andSNAPPE-Ⅱ(P=0.27), and the TRIPS was the best. TRIPS, SNAP-ⅡandSNAPPE-Ⅱ discriminated7-day mortality with receiver operatingcharacteristic area (AUC) of0.80,0.82and0.84, respectively, whereas the predictive performance for severe IVH was0.70,0.69and0.83, and theperformance for MV of0.72,0.72and0.74, respectively. There was nosignificant difference among these three scoring systems (P＞0.05). Forgestational age at transport≤30weeks, the AUC for TRIPS was0.83,whereas the AUC for gestational age at transport＞30weeks was0.81for7-day mortality. With the cut-off value of20points, the sensibility ofTRIPS predicting7-day mortality and MV were89.1%and72.5%,respectively, whereas the specificity of57.7%and66.8%.Conclusion:Compared with SANP-Ⅱ, SNAPPE-Ⅱ and NCIS, TRIPS is moresuitable for quick severity evaluation due to its simplicity and feasibility,especially in accurately predicting7-day mortality, severe IVH and MV oftransported neonates. This scoring system had a good performance toassess illness severity, mainly neonates with gestational age attransport≤30weeks and points≥20.