Objective: To evaluated the correlation of glucose fluctuation, critical illness scores and 28-day mortality in patients with severe pneumonia and diabetes.Methods: A Total of eighty-four patients with severe pneumonia and diabetes were enrolled in this study and divided into death group(n=25) and survival group(n=59). All patients were received glucose fluctuation and critical illness score evaluation. The blood glucose on admission(BGad), mean blood glucose(BGm), standard deviation blood glucose(BGsd) and coefficient of variation (GLUcv) were calculated in each patient, coefficient of blood glucose variability(BGcv) and blood glucose instability index(BGI) were used as glucose swing estimation values. APACHE Ⅱ, SOFA, qSOFA, MEWS and SARS Ⅲ were used as critical evaluation index.Results: The numbers of continuous renal replacement therapytreatment and the days of mechanical ventilation, ICU hospital day and total hospital day in death group were higher than those in survival group(P<0.05). The levels of BGsd[(2.4±0.8) mmol·L-1 vs (1.6±0.5) mmol·L-1,P<0.001], BGcv[(44.32±5.66)% vs (21.53±4.81)%,P<0.001] and BGI[(12.52±2.32)(mmol·L-1)2·h-1·d-1 vs (5.39±1.14)(mmol·L-1)2·h-1·d-1,P<0.001] in death group were higher than those in survival group. ROC analysis showed that the AUC of BGcv and BGI for 28-day mortality were 0.846 and 0.857, respectively. The cut-off value of BGcv and BGI were 51.3 and 15.7, respectively. Correlation analysis showed that BGcv and BGI were positively related with 28-day mortality.Conclusion: BGcv and BGI may be used as blood glucose fluctuation value for early prognosis in severe pneumonia patients with diabetes mellitus.
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