Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Brigadeiro, São Paulo, Brazil.
Am J Perinatol. 2012 Aug;29(7):509-14. doi: 10.1055/s-0032-1310521. Epub 2012 Apr 11.
To evaluate the performance of the Transport Risk Index of Physiologic Stability (TRIPS) score at admission for early mortality prediction.
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.
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.
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.
评估入院时生理稳定转运风险指数（TRIPS）评分在早期死亡率预测中的表现。
本研究纳入了在 3 年内连续入住单一一所新生儿重症监护病房（NICU）的所有外地产儿。收集的数据包括人口统计学变量、7 天 NICU 死亡率、严重（≥3 级）脑室出血（IVH）、入院时 TRIPS 评分以及新生儿急性生理学评分 II（SNAP-II）和围生期扩展 II 评分（SNAPPE-II）。
共纳入 175 例新生儿。TRIPS 在入院时区分了 7 天死亡率和存活率，ROC 曲线下面积为 0.80，TRIPS 对严重 IVH 的预测性能显示 ROC 曲线下面积为 0.67。TRIPS 在所有亚组的校准情况均良好（p=0.49）。对于胎龄（GA）>32 周，TRIPS 的曲线下面积（AUC）为 0.71，而 GA≤32 周的 AUC 为 7 天死亡率的 0.99。TRIPS 对 7 天死亡率的预测性能与 SNAP-II 和 SNAPPE-II 相似。
入院时 TRIPS 评分能够很好地区分 7 天死亡率高风险患者，主要是 GA≤32 周的婴儿。如果在与转运服务首次接触时应用 TRIPS，它可能是一种有用的分诊工具。
