Association Between Blood Glucose Coefficient Of Variation And SNAPPE-Ⅱ Score And Prognosis In Critical Neonates

Objective: To explore association between blood glucose coefficient of variation and SNAPPE-score and prognosis in critically ill neonates.Methods: Through retrospective study methods,a total of 385 hospitalized neonates were collected in the Department of NICU,Affiliated Hospital of Southwest Medical University from August 2018 to September 2020.To collect the general data on each critical newborn(gestational age,birth weight,age of admission,gender,maternal gestational diabetes,time of mechanical ventilation,main diagnosis,prognosis),blood glucose data were monitored and the coefficient of glycemic variation(CV)was calculated,as well as the Score for Neonatal Acute Physiology Perinatal Extension II(SNAPPE-Ⅱ)related data.According to the prognosis,they were divided into good prognosis and poor prognosis.The differences in general data,CV and SNAPPE-Ⅱscore were compared.Different data were correlated with CV.Multivariate logistic regression models were used to explore adverse risk factors.The diagnostic value of CV and SNAPPE-Ⅱ score for poor prognosis was evaluated by using the area under the ROC curve(AUC),sensitivity and specificity.Results:1 Comparison between the two groups: CV,mean blood glucose,initial blood glucose,SNAPPE-Ⅱ score,hospital days,ventilator days,age,gestational age,birth weight,diagnosis type,hypoglycemia prevalence,and hyperglycemia prevalence were all statistically significant(P<0.05).2 The Spearman correlation analysis suggested that there was a significant positive correlation between CV and SNAPPE-Ⅱscore,poor prognosis and days of mechanical ventilation,and there was a significant negative correlation between CV and the blood glucose concentration at admission,gestational age,birth weight,and major diagnosis(P < 0.01).3 The results of multivariate logistic regression analysis showed that CV,SNAPPE-Ⅱ score and pulmonary hemorrhage were the risk factors for poor prognosis.4 ROC curve analysis showed that area under the curve(AUC)of CV and SNAPPE-Ⅱ score were 0.716(95%CI:0.655～0.776,P<0.01)、0.848(95%CI:0.793～0.903,P< 0.01).CV and SNAPPE-Ⅱ scores have good predictive value for prognosis.Conclusions: The coefficient of glycemic variation was associated with neonatal SNAPPE-Ⅱ score and poor prognosis.The higher the coefficient of variation and the higher the SNAPPE-Ⅱ score,the higher the critical condition and the greater the risk of poor prognosis.