A Prospective Observational Study To Evaluate TOPS Score As An Outcome Predictor In Extramural Referred Neonates Admitted At A Tertiary Care Center

Background:The neonatal period is the most vulnerable time for a child's survival. As survival perspective of extramural neonates significantly relies on the state of neonate at admission, various survival scores like CRIB, SNAP, MINT, TRIPS, TOPS etc. are designed to prognosticate the outcome of neonate at admission. This study was de signed to delineate correlation of TOPS score with outcome of referred neonates.Aims And Objectives:To recognise correlation of TOPS score with outcomes of extramural neonates. Material And Methods:It was prospective observational study conducted from September 2019 to February 2020 at nicu of tertiary care hospital. Clinico-demographic characteristics and TOPS score were documented in a pre-designed proforma. Hypothermia, Hypoxia, prolonged CRT and Hypoglycemia were defined as<36.5C, <90%, ?3 secs and <40mg/dl respectively. Each parameter was assigned a score of ‘1’ if abnormal and ‘0’ if normal. Neonates were treated as per standard protocol and their outcome was recorded as survive d or expired. Result:Out of 239 neonates 140 (58.6%) were males and 99 (41.5%) were females. The area under the ROC curve (AUROC) for TOPS Total predicting Outcome: Expired vs Outcome: Survived was 0.932. At a cut-off of TOPS Total ?2, it predicts Outcome: Expired with a sensitivity of 83% and a specificity of*The relative risk (95% CI) for Outcome: Expired when TOPS Total is ?2 was 25.68.Hypothermia (Chi-squared test, ?2 = 38.462, p = <0.001), hypoxia (Fisher's exact test, ?2 = 122.636, p = <0.001), poorperfusion (shock) (Fisher's exact test, ?2 = 103.563, p = <0.001) are found to be significantly associated with poor outcome. Conclusion:TOPS score is an easy, reliable and applicable tool for outcome prediction of transported neonates.