Transport Risk Index of Physiologic Stability, Version II (TRIPS-II): A Simple and Practical Neonatal Illness Severity Score

Shoo K. Lee; Khalid Aziz; Michael Dunn; Maxine Clarke; Lajos Kovacs; Cecil Ojah; Xiang Y. Ye; for The Canadian Neonatal Network

doi:10.1055/s-0032-1326983

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(05): 395-400
DOI: 10.1055/s-0032-1326983

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Transport Risk Index of Physiologic Stability, Version II (TRIPS-II): A Simple and Practical Neonatal Illness Severity Score

Authors

Shoo K. Lee

¹Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

²Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
Khalid Aziz

³Department of Pediatrics, University of Alberta, Edmonton, Alberta
Michael Dunn

¹Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
Maxine Clarke

⁴Department of Pediatrics, Queen's University, Kingston, Ontario, Canada
Lajos Kovacs

⁵Department of Pediatrics, McGill University, Montreal, Quebec
Cecil Ojah

⁶Department of Pediatrics, Saint John Regional Hospital, Saint John, New Brunswick, Canada
Xiang Y. Ye

²Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada

for The Canadian Neonatal Network

Abstract

Objective Derive and validate a practical assessment of infant illness severity at admission to neonatal intensive care units (NICUs).

Study Design Prospective study involving 17,075 infants admitted to 15 NICUs in 2006 to 2008. Logistic regression was used to derive a prediction model for mortality comprising four empirically weighted items (temperature, blood pressure, respiratory status, response to noxious stimuli). This Transport Risk Index of Physiologic Stability, version II (TRIPS-II) was then validated for prediction of 7-day and total NICU mortality.

Results TRIPS-II discriminated 7-day (receiver operating curve [ROC] area, 0.90) and total NICU mortality (ROC area, 0.87) from survival. Furthermore, there was a direct association between changes in TRIPS-II at 12 and 24 hours and mortality. There was good calibration across the full range of TRIPS-II scores and the gestational age at birth, and addition of TRIPS-II improved performance of prediction models that use gestational age and baseline population risk variables.

Conclusion TRIPS-II is a validated benchmarking tool for assessing infant illness severity at admission and for up to 24 hours after.

Keywords

neonates - mortality - risk adjustment - outcomes

Full Text

References

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