Clinical impact of improved point-of-care glucose monitoring in neonatal intensive care using Nova StatStrip: Evidence for improved accuracy, better sensitivity, and reduced test utilization

• A chart review was performed in the NICU to investigate the impact of switching from the LifeScan SureStep Flex to Nova StatStrip glucose meter.
• Improved analytical performance of StatStrip was associated with better agreement and less bias against venous plasma glucose measurements.
• StatStrip showed improved sensitivity for detection of critically low results in critically-ill neonates at risk of hypoglycemia.
• Reduced frequency of testing in neonates using StatStrip was also observed, reflecting improved meter utilization in the NICU.

ObjectivesStudies have demonstrated improved analytical performance of the Nova StatStrip glucose meter, but limited data is available on its clinical performance in critically ill neonates in the neonatal intensive care unit (NICU).Design and methodsA retrospective charge review was conducted on 651 neonates admitted to the NICU over 2 years. Demographics, sample collection information, and clinical details were recorded. Glucose measurements were performed at the bedside using either the Nova StraStrip or LifeScan SureStep Flexx meters as well as corresponding measurements of laboratory venous plasma glucose. Performance was analyzed by receiver operator characteristic (ROC) curves for detecting hypoglycemia and critical glucose levels.ResultsLinear regression analysis comparing StatStrip and laboratory venous plasma glucose samples demonstrated significantly tighter agreement (r2 = 0.7994) and accuracy (mean bias = 0.13 mmol/L) than SureStep (r2 = 0.6845 and mean bias = 0.53 mmol/L). StatStrip also showed improved sensitivity for detecting critical low glucose values ≤ 3.0 mmol/L (80.9 vs 68.9%, p < 0.05). ROC curve analysis further demonstrated excellent performance of StatStrip at this cutoff with an AUC of 0.98. Overall, neonates were also tested significantly less frequently with the StatStrip meter by 24% compared to SureStep.ConclusionsImplementation of StatStrip led to better agreement with venous plasma glucose, improved detection of critical low glucose results, and more efficient test utilization. This study demonstrates the importance of accurate and sensitive glucose monitoring in the NICU.