TRIPS
Description
assessment of the patient’s condition and prediction of outcomes is critically important during pre-transport stabilization and remains the most complex challenges of the activities of transport teams. A significant variety of scales and different requirements for their application indicates that there is no consensus on the choice of a specific scale and predictive tool. OBJECTIVE: To study hospital outcomes in transported newborns, depending on the assessment on the TRIPS scale (Transport Risk Index of Physiological Stability for Newborn Infants). The observational, cohort, retrospective study included data from all departures of the transport team of the resuscitation and advisory Center of the Regional Children's Clinical Hospital of Yekaterinburg in the period from August 1, 2017 to December 31, 2018. After excluding patients with congenital pathology requiring urgent surgical intervention, the number of cases was 640. The full amount of data or outcomes were not available for 36 cases. The final sample consists of 604 cases of the transport team trips to 564 newborn children hospitalized in medical organizations of the Sverdlovsk region and being under remote observation of the intensive care center due to the severity of the condition. The primary medical documentation was the data source for the formation of the TRIPS scale assessment and registration of hospital stage outcomes. Anamnesis data, TRIPS scores were analyzed, divided into groups according to the assessment (the first - 0-7 points, the second - 8-16 points, the third - 17-23 points, the fourth - 24-30 points, the fifth - 31-38 points, the sixth 39 or more points, Fig.1). The comparison of the parameters and volume of intensive care, the outcomes of the hospital stage (death, death up to 7 days of life, late onset sepsis (LOS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage of 1-2 degrees (IVH 1-2), intraventricular hemorrhage of 3-4 degrees (IVH 3-4), occlusive hydrocephalus (occlution), air leakage syndrome (airleak)) in groups. The total number of deaths in the study sample was 38 out of 564 newborns (6.74%). Of the 497 evacuated newborns, 25 children (5.03%) died, of the 67 newborns left in the medical organizations that applied, 13 patients (19.40%) died.
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Statistical processing: median and inter-quarter interval, fraction, 95% CI of the fraction, the Chi-square criterion was applied to the analysis of binary data of three or more independent groups, the Kraskal-Wallis criterion was applied to the analysis of quantitative data of three or more independent groups. The calculation of relative risk is applied when comparing the probability of occurrence of outcomes between groups. The differences were considered statistically significant at p<0.005. Software tools Biostar Pro 7.0.1.0. ((Analystsoft Inc., USA) and Matlab R2017a. (The MathWorks, Inc., USA).