Observational studyBMC pregnancy and childbirth2022
Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study.
Observational study in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Contemporary Evidence on Interhospital Neonatal Transport as a Potentially Sepsis-Relevant Care Interval: A Scoping Review.Medicina (Kaunas, Lithuania) · 2026Article
- The Relationship Between TRIPS, MINT, SNAPPE-II Scores, and Mortality in Newborns Transported Within the First 24 h of Birth.Journal of clinical medicine · 2026Article
- Assessment of Skin Maturity by LED Light at Birth and Its Association With Lung Maturity: Clinical Trial Secondary Outcomes.JMIR biomedical engineering · 2023Article
- Identification of the Best Predictive Model for Mortality in Outborn Neonates-Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2023Article
- Improving the Treatment of Neonatal Sepsis in Resource-Limited Settings: Gaps and Recommendations.Research and reports in tropical medicine · 2023Review
- Outborn newborns drive birth asphyxia mortality rates-An 8 year analysis at a rural level two nursery in Uganda.PLOS global public health · 2023Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessing the severity of transferred neonates at admission can improve resource allocation. This study evaluated the role of TOPS (illness severity score including temperature, oxygen saturation, skin perfusion and blood sugar) in predicting mortality in neonates transferred by ambulance in a low-resource setting.
methodsThe study was conducted at Beira Central Hospital (Mozambique). Infants who were transferred by ambulance to the Neonatal Intensive Care Unit between 16th June and 16th October 2021 were included. The association between TOPS and mortality was investigated with a logistic regression model. Receiver-operating characteristics (ROC) curve was derived for TOPS; area under the ROC curve, sensitivity and specificity were calculated.
resultsIn-transport mortality was 2/198 (1.0%) and in-hospital mortality was 75/196 (38.3%). Median gestational age and birthweight were 38 weeks and 2600 g. Main causes of admission were asphyxia (29.3%), prematurity (25.3%) and sepsis (22.7%). Hypothermia and oxygen desaturation at admission were 75.8% and 32.3%. TOPS ≥ 1 was associated with increased mortality risk (odds ratio 7.06. 95% confidence interval 1.90 to 45.82), with 0.97 sensitivity and 0.26 specificity.
conclusionsThe high mortality rate calls for interventions and quality initiative studies to improve the transfer process and the conditions at admission. TOPS can be used to identify neonates at risk of mortality and concentrate efforts of health care providers. Interventions preventing hypothermia and oxygen desaturation should be implemented in pre-transport stabilization and care during transport.
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