Association between Transport Risk Index of Physiologic Stability (Trips) in Extremely Premature Infants and Mortality or Neurodevelopmental Impairment at 18 to 24 Months.

Abstact Objectives To examine the association between mortality or neurodevelopmental impairment at 18-24 months of corrected age and the Transport Risk Index of Physiologic Stability (TRIPS) score on admission to the neonatal intensive care unit (NICU) in extremely premature infants. Study design Retrospective cohort study of extremely premature infants (inborn and outborn) born at 22-28 weeks of gestational age (GA) and admitted to NICUs in the Canadian Neonatal Network (CNN) between 4/2009 and 9/2011. TRIPS scores and clinical data were collected from the CNN database. Follow-up data at 18-24 months of corrected age were retrieved from the Canadian Neonatal Follow-Up Network database. Neurodevelopment was assessed using the Bayley Scales of Infant and Toddler Development, Edition III (Bayley-III). The primary outcome was death or significant neurodevelopmental impairment at 18-24 months of corrected age. The secondary outcomes were individual components of the Bayley-III assessment. Results A total of 1686 eligible infants were included. A TRIPS score ≥20 on admission to the NICU was significantly associated with mortality (adjusted odds ratio 2.71 [2.02-3.62]) and mortality or significant neurodevelopmental impairment (adjusted odds ratio 1.91 [1.52-2.41]) at 18-24 months of corrected age across all GA groups of extremely premature infants. Conclusion The TRIPS score on admission to the NICU can be used as an adjunctive, objective tool for counselling the parents of extremely premature infants early after their admission to the NICU.