European Journal of Molecular & Clinical Medicine

Abstract

Background- Neonates show clinical signs prior to acute deterioration which are usually unrecognized. Whitt’s neonatal trigger score (W-NTS) with high sensitivity(77%) and specificity(97%) was developed in 2010 for early detection of neonates who are at risk of deterioration. The aim of our study was to assess the applicability of W-NTS for early detection of at risk neonates in Indian population. Method- A ProspectiveObservational study was conducted over a period of 24 months on stable neonates with predefined risk factors in the postnatal ward. The scores were calculated using 6 clinical parameters Heart rate, Respiratory rate, Temperature, Respiratory distress, Level of activity, and RBS readings  and were recorded on W-NTS chart. Each parameter score minimum of 0, and maximum ranging from 1 to 3. The score from each separate parameter was then combined to generate a cumulative score (minimum 0, maximum 15). Neonates were divided into 3 groups Group 1 (score 0): who remained well in the PNW, Group 2 (score 1): neonates requiring septic screen and antibiotics therapy, Group 3(score ≥2): required admission to the NICU. Results- Out of 853 neonates ,683(80.07%) belonged to group 1, 23(2.7%) belonged to group 2, whereas 136(17.23%) belonged to group 3(P<0.001). Septic screen was done for all neonates in group 2 and 3. Neonates who belonged to group 2 had negative results were successfully discharged, whereas in group 3 ,62 out of 143 had positive septic screening results, out of which 11 died and 136 were successfully discharged. Conclusion-This W-NTS score is highly usefull for early detection of deterioration in neonates with high risk factors. The score is highly reliable and easy to perform.