Impacto de la calidad del transporte en la estabilidad clínica neonatal : uso del TRIPS II.

Abstract

Introduction: Neonatal transport is a critical time for newborns requiring specialized care. The quality of this transport can significantly determine prognosis and survival. This study evaluated the quality of neonatal transport using the TRIPS II index to determine its impact on clinical stability and early mortality. Methodology: A prospective observational cohort-correlational study with longitudinal design was performed. We analyzed 130 newborns admitted to a national reference hospital between June and August 2024, transferred from type A (hospitals with limited resources) and type B (hospitals with complete resources) institutions. The TRIPS II index was used to assess physiological stability at admission and at 12 hours. Neonatal variables, transport factors and institutional resources were analyzed, calculating odds ratios (OR) with 95% confidence intervals. Results: Incomplete human and material resources showed significant inverse associations (OR: 3.03; 95% CI: 0.46-3.14). Variables such as weight ≤1500g (OR: 1.58; 95% CI: 0.495-5.038) and gestational age <30 weeks (OR: 1.8; 95% CI: 0.529-6.129) lost statistical significance after 12 hours in the NICU. Neonates with TRIPS II score ≥20 at admission had a higher risk of mortality (OR: 2.08), increasing significantly when this score persisted at 12 hours (OR: 7.81). Type A institutions presented significantly higher TRIPS II scores at admission (20.87±11.32 vs. 14.23±9.43 in type B). Conclusions: The TRIPS II index is an effective predictor of neonatal mortality, especially when high scores persist after 12 hours of admission. The availability of human and material resources during transport significantly influences the clinical stability of the neonate.