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Study of Referral Pattern of Neonates at Tertiary Care Centre and Role of TOPS Score in Assessing Morbidity and Mortality

Author:Zankhana R Parekh, Rishab Bharadwaj, Gayatri Parmar, Aasheeta Shah

Keywords:Neonate, TOPS score, Morbidity, Mortality

Type:Original Article

Abstract:"Objective: This study was aimed to find out characteristics of transport of a sick referred neonate and to measure the risk factors that contribute to mortality. Methods: In this prospective cross-sectional study, a total of 150 neonates were studied who referred from peripheral hospitals and admitted in the tertiary care hospital. Data collected included referral and transport characteristics and clinical parameters at the time of admission including TOPS score (Temperature, Oxygenation, Pulse and Sugar). Results: Most of neonatal referrals were self or improperly organized transport and associated with inadequate pre-referral stabili-zation, incomplete advice regarding care during transport and poor communication. Out of 150 neonates, TOPS score was 0 in 21.7%, 1 in 36%, 2 in 21.3%, 3 in 14% and 4 in 7% of neonates. 100% of neonates with a TOPS score of 4 on admission expired. Conclusion: This study highlights the fact that a large number of neonatal deaths can be prevented by early identification, appropriate pre-referral stabilisation, improved communication and an effective transport system in place for safe referral of neonates to higher centres for management. The TOPS scoring system can serve as a guide for the paediatrician in initiating appropriate revival and/or treatment measures