The use of severity assessment scales in evaluating the transportability of newborns: a cohort retrospective study

Abstract

Introduction. Standardized assessment of the patient status and the decision on the possibility of transfer is an essential part of the neonatal transport service. However, there are no generally accepted tools for assessing severity and making decisions regarding newborn transfer. Objectives. To compare the capabilities of scales in relation to the decision about the non-transportability of newborns. Materials and Methods. The cohort study included data from 604 trips of the transport team of the neonatal resuscitation and consultation center. The assessment was carried out on the KSHONN, NTISS and TRIPS scales, the distribution of transportable and non-transportable patients was studied depending on the assessment for each scale. The calculation of the risk ratio of nontransportation was performed depending on the assessment on the scales. AUC ROC was calculated for all scales in relation to the decision of transport team about the patient’s non-transportability. Results. The scores on the scales significantly differ between the subgroups of transportable and non-transportable newborns, p < 0.0001. Significant differences in subgroup distribution were observed depending on the scores between transportable and nontransportable patients. When evaluated by KSHONN 6-8 points, the risk ratio of non-transportability was 61.36 [3.77-999.47]. For NTISS of 20-29 points, the risk ratio of non-transportability was 51.37 [3.18-829.11]. When evaluated by TRIPS 17-23 points, the risk ratio of nontransportability was 18.81 [1.09 - 327.26]. Conclusions. Scales have a high predictor value in relation to the decision of the transport team about the non-transportability of patients. Comparison of the subgroups by the proportion of non-transportable patients indicates that a score of more than 5 according to the KSHONN, more than 19 points on the NTISS scale and more than 16 points on the TRIPS scale are associated with a significant increase in the risk of non-transportability.