Prognostic Role of Temperature Oxygenation Perfusion Sugar (TOPS) score in Outborn Transported Neonates in a Tertiary Care Center—A Prospective Cohort Study

Abstract

Background

Neonatal outcomes are affected by the acute physiologic derangements of neonatal vitals, such as temperature, blood sugar (GRBS), perfusion, and oxygenation. The aim was to correlate the temperature oxygenation perfusion sugar (TOPS) score of outborn neonates transported with the morbidity and mortality during hospitalization in the neonatal intensive care unit (NICU).

Methods

Five hundred transported neonates were enrolled in this prospective cohort study by scoring TOPS vitals within an hour of NICU admission, and the outcomes were assessed after 72 hours of hospitalization.

Results

Among 500 neonates, hypoglycemia, hypoperfusion, hypoxemia, and hypothermia were found in 13%, 32%, 30%, and 37%, respectively. One hundred five (21%) neonates did not survive. Hypoxemia (82%) was the most common parameter, followed by hypoperfusion (78%) among the nonsurvivor neonates. Neonates with a TOPS score of zero survived, whereas neonates with a TOPS score of four had 100% mortality. TOPS SCORE’s overall sensitivity and specificity were reported at 87% and 84%, respectively, with 59% positive and 96% negative predictive values. TOPS score ≥2 had a receiver operating characteristic (ROC) curve at 0.91. Hypoxemia (82%) was the most sensitive parameter to predict mortality, followed by poor perfusion (77%).

Conclusion

The prognostication of mortality in transported neonates can be assessed by the TOPS score, as mortality notably increases with an increase in the TOPS score. A TOPS score of ≥2 was a good predictor of morbidity and mortality in transported neonates.