Prognostic Outcome of Neonates Admitted to a Neonatal Intensive Care Unit Using Stops Scoring at a Tertiary Care Hospital in Puducherry, India

Background: Neonates admitted to intensive care usually are presented with widely varying degrees of physiological instability. Early assessment of illness severity is important as it helps clinicians identify infants who require closer observation and prompt intervention. The STOPS score based on Sensorium, Temperature, Oxygenation, Perfusion and Sugar a bedside clinical scoring system developed to assess neonatal illness severity. This study examines the relationship between STOPS scores and clinical outcomes in neonates admitted to a tertiary-care NICU in Puducherry. Methods: A prospective observational study was conducted in the neonatal intensive care unit in a tertiary care centre at Puducherry. Neonates aged 0–28 days who met the study criteria were included. STOPS scores were recorded at admission (0 hours), 6 hours and 12 hours. Clinical characteristics and outcomes were analysed using descriptive statistics and chi-square tests. A p value <0.05 was considered statistically significant. Results: A total of 152 neonates were included in the reported analysis. There were 90 males (59.2%) and 62 females (40.8%). Sixty neonates (39.5%) were born at ≤37 weeks' gestation. Normal birth weight was recorded in 69.1%, low birth weight in 15.8% and very low birth weight in 11.2%. Twelve neonates (7.9%) died, 123 (80.9%) were discharged, eight (5.3%) were referred and nine (5.9%) had a prolonged hospital stay before discharge. A STOPS score >2 was recorded in 17.8% at 0 hours, 10.5% at 6 hours and 9.9% at 12 hours. STOPS category was significantly associated with outcome at all three time points (0 hours, p<0.001; 6 hours, p=0.045; 12 hours, p<0.001). Conclusion: In this single-centre cohort, higher STOPS scores were associated with less favourable clinical outcomes at 0, 6 and 12 hours. The findings support the use of STOPS as a simple bedside assessment of neonatal physiological status. However, formal prognostic accuracy cannot be established from the present data because measures such as ROC-AUC, sensitivity and specificity were not reported.