Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study
Abstract Background Assessing the severity of transferred neonates at admission can improve resource allocation. This study evaluated the role of TOPS (illness severity score including temperature, oxygen saturation, skin perfusion and blood sugar) in predicting mortality in neonates transferred by...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05060-9 |
| _version_ | 1828235303646658560 |
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| author | Francesco Cavallin Annaelena Contin Natércia Alfeu Belinda Macmillian Amir Hussein Abubacar Seni Bonifacio Rodriguez Cebola Serena Calgaro Giovanni Putoto Daniele Trevisanuto |
| author_facet | Francesco Cavallin Annaelena Contin Natércia Alfeu Belinda Macmillian Amir Hussein Abubacar Seni Bonifacio Rodriguez Cebola Serena Calgaro Giovanni Putoto Daniele Trevisanuto |
| author_sort | Francesco Cavallin |
| collection | DOAJ |
| description | Abstract Background Assessing the severity of transferred neonates at admission can improve resource allocation. This study evaluated the role of TOPS (illness severity score including temperature, oxygen saturation, skin perfusion and blood sugar) in predicting mortality in neonates transferred by ambulance in a low-resource setting. Methods The study was conducted at Beira Central Hospital (Mozambique). Infants who were transferred by ambulance to the Neonatal Intensive Care Unit between 16th June and 16th October 2021 were included. The association between TOPS and mortality was investigated with a logistic regression model. Receiver-operating characteristics (ROC) curve was derived for TOPS; area under the ROC curve, sensitivity and specificity were calculated. Results In-transport mortality was 2/198 (1.0%) and in-hospital mortality was 75/196 (38.3%). Median gestational age and birthweight were 38 weeks and 2600 g. Main causes of admission were asphyxia (29.3%), prematurity (25.3%) and sepsis (22.7%). Hypothermia and oxygen desaturation at admission were 75.8% and 32.3%. TOPS ≥ 1 was associated with increased mortality risk (odds ratio 7.06. 95% confidence interval 1.90 to 45.82), with 0.97 sensitivity and 0.26 specificity. Conclusions The high mortality rate calls for interventions and quality initiative studies to improve the transfer process and the conditions at admission. TOPS can be used to identify neonates at risk of mortality and concentrate efforts of health care providers. Interventions preventing hypothermia and oxygen desaturation should be implemented in pre-transport stabilization and care during transport. |
| first_indexed | 2024-04-12T20:12:09Z |
| format | Article |
| id | doaj.art-142b30abd93b486d93e87625c6288091 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T20:12:09Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-142b30abd93b486d93e87625c62880912022-12-22T03:18:13ZengBMCBMC Pregnancy and Childbirth1471-23932022-09-012211910.1186/s12884-022-05060-9Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational studyFrancesco Cavallin0Annaelena Contin1Natércia Alfeu2Belinda Macmillian3Amir Hussein Abubacar Seni4Bonifacio Rodriguez Cebola5Serena Calgaro6Giovanni Putoto7Daniele Trevisanuto8Independent StatisticianDoctors With Africa CUAMM MozambiqueDepartment of Pediatrics, Beira Central HospitalDepartment of Pediatrics, Beira Central HospitalDepartment of Pediatrics, Beira Central HospitalDepartment of Pediatrics, Beira Central HospitalDoctors With Africa CUAMM MozambiqueDoctors With Africa CUAMMDepartment of Woman’s and Child’s Health, University Hospital of PaduaAbstract Background Assessing the severity of transferred neonates at admission can improve resource allocation. This study evaluated the role of TOPS (illness severity score including temperature, oxygen saturation, skin perfusion and blood sugar) in predicting mortality in neonates transferred by ambulance in a low-resource setting. Methods The study was conducted at Beira Central Hospital (Mozambique). Infants who were transferred by ambulance to the Neonatal Intensive Care Unit between 16th June and 16th October 2021 were included. The association between TOPS and mortality was investigated with a logistic regression model. Receiver-operating characteristics (ROC) curve was derived for TOPS; area under the ROC curve, sensitivity and specificity were calculated. Results In-transport mortality was 2/198 (1.0%) and in-hospital mortality was 75/196 (38.3%). Median gestational age and birthweight were 38 weeks and 2600 g. Main causes of admission were asphyxia (29.3%), prematurity (25.3%) and sepsis (22.7%). Hypothermia and oxygen desaturation at admission were 75.8% and 32.3%. TOPS ≥ 1 was associated with increased mortality risk (odds ratio 7.06. 95% confidence interval 1.90 to 45.82), with 0.97 sensitivity and 0.26 specificity. Conclusions The high mortality rate calls for interventions and quality initiative studies to improve the transfer process and the conditions at admission. TOPS can be used to identify neonates at risk of mortality and concentrate efforts of health care providers. Interventions preventing hypothermia and oxygen desaturation should be implemented in pre-transport stabilization and care during transport.https://doi.org/10.1186/s12884-022-05060-9Neonatal transportMortalityTOPSLow-resource setting |
| spellingShingle | Francesco Cavallin Annaelena Contin Natércia Alfeu Belinda Macmillian Amir Hussein Abubacar Seni Bonifacio Rodriguez Cebola Serena Calgaro Giovanni Putoto Daniele Trevisanuto Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study BMC Pregnancy and Childbirth Neonatal transport Mortality TOPS Low-resource setting |
| title | Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study |
| title_full | Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study |
| title_fullStr | Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study |
| title_full_unstemmed | Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study |
| title_short | Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study |
| title_sort | prognostic role of tops in ambulance transferred neonates in a low resource setting a retrospective observational study |
| topic | Neonatal transport Mortality TOPS Low-resource setting |
| url | https://doi.org/10.1186/s12884-022-05060-9 |
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