Assessing Outcome in Interhospital Infant Transport: the Transport Risk Index of Physiologic Stability Score at Admission

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Lucas da Silva, Paulo Sergio
Aguiar, Vania Euzebio de
Reis, Maria Eunice
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Objective To evaluate the performance of the Transport Risk Index of Physiologic Stability (TRIPS) score at admission for early mortality prediction.Methods the study included all consecutive outborn infants admitted to a single neonatal intensive care unit (NICU) over a 3-year period. the data collected included demographic variables, 7-day NICU mortality, and severe (>= grade 3) intraventricular hemorrhage (IVH), TRIPS score at admission, and Score for Neonatal Acute Physiology II (SNAP-II) and SNAP-Perinatal Extension-II (SNAPPE-II) scores.Results A total of 175 neonates were enrolled. TRIPS at admission discriminated 7-day mortality from survival with a receiver operating characteristic (ROC) area of 0.80, and predictive performance of TRIPS for severe IVH showed a ROC area of 0.67. the TRIPS had good calibration for all strata (p 0.49). for gestational age (GA) > 32 weeks, the area under the curve (AUC) for TRIPS was 0.71, whereas the AUC for GA <= 32 weeks was 0.99 for 7-day mortality. Predictive performance of TRIPS for 7-day mortality was similar to that of SNAP-II and SNAPPE-II.Conclusion TRIPS score at admission had a good performance to discriminate high-risk patients for 7-day mortality, mainly infants with GA <= 32 weeks. TRIPS might be a useful triage tool if applied at the time of first contact with a transport service.
American Journal of Perinatology. New York: Thieme Medical Publ Inc, v. 29, n. 7, p. 509-514, 2012.