Glycosylated haemoglobin (HbA1c) and cortisol levels on admission to intensive care as predictors of outcome

Objective: To evaluate the predictive value of glycosylated haemoglobin and cortisol on admission, in critical care patients. Design: Prospective, observational, single centre study. Setting: 14 bedded Intensive care unit of a tertiary-level university hospital. Patients: 124 consecutive emergency medical and surgical patients. Methods: Data collected on admission included patient demographics, medical history, medication, diagnosis, type of nutrition, TISS28 score, serum blood glucose, Glycosylated haemoglobin (HbA1c), cortisol, mean arterial blood pressure, and the use of inotropes in the first 24hrs. Daily baseline tests included complete blood count, urea and electrolytes, creatinine, twice weekly liver function tests. The primary outcome measure was intensive care unit mortality. Secondary outcome measures were ITU stay, days of ventilation, peak urea, peak creatinine, lowest platelet count, peak bilirubin, lowest Pa/FiO2, and the number of transfusions. Measurements and results: 124 patients (mean age 56.2 years SD 23.2) were included. Regression analysis was used to identify any potential predictors of outcome: HbA1c levels on admission were not found to be significantly associated with mortality (p=0.51), or any other secondary endpoints listed above. However, subgroup analysis revealed a predictive role of HbA1c with regards to length of ITU stay (p= 0.01) and number of days of ventilation (p=0.007) in those patients with a history of diabetes. Glucose level on admission emerged as an independent marker of mortality (p=0.009). Conclusions: This study suggests that HbA1c may not be a predictor of outcome in the general ITU population but may be of predictive value in diabetic ITU patients. On the other hand, blood glucose levels on admission emerged as a predictor of mortality, whilst no association was found between HbA1c and cortisol levels on admission.peer-reviewe

Hawn jien, Ġesù...

Ġabra ta’ poeżiji u proża li tinkludi: Biex nagħarfu ngħixu ta’ G. Z. A. – Il-qalb ta’ John Sciberras – L-istedina ta’ Vic. Apap – Lill-bniedem ta’ Joseph C. Sciberras – Il-hena ta’ tfuliti ta’ George Stevens – L-ewwel ta’ Mejju ta’ Karmenu Ellul Galea – Epigrammi ta’ Pawlu Cachia – Ġibtlek bukkett ġilju ta’ Ġużè Galea – De profundis ta’ A. Agius Muscat – Did-dwejra bħal ħajja ta’ Ġużè Cardona – Ma’ dik li ġejja mill-bogħod ta’ Joe Mejlak – Hawn jien, Ġesù... ta’ Bro. Henry.peer-reviewe

Lil Dun Karm

Ġabra ta’ poeżiji u proża li tinkludi: Qalb ta’ Peter A. Caruana – Ċetta l-internazzjonal ta’ Wallace Ph. Gulia – Tfal Maltin ta’ C. Cassar – Meta ntefa d-dawl ta’ Joe Mejlak – Lil tfajjel jibki ta’ V. Barbara – Għanja lil San Pawl il-Baħar ta’ P. F. Sammut – L-imqass ta’ G. Z. A. – Epigrammi ta’ P. P. Saydon – Iż-żewġ arloġġi ta’ Ġ. Cardona – Li kieku... ta’ Joseph C. Sciberras – Il-Milied it-tajjeb! ta’ Ġ. Borg Pantalleresco – Raħal twelidi ta’ M. Agius – Kannizzati... ta’ Pawlu Aquilina – Quddiem id-dar fejn twieled Dun Karm ta’ Ġużè Cardona – Lil Dun Karm ta’ Pawlu Mifsud.peer-reviewe

Karmenu Vassallo fil-poeżija reliġjuża

Fost it-temi li nisiltu mill-poeżija ta’ Karmenu Vassallo nsibu t-tema reliġjuża. Għalhekk, l-awtur jagħmel apprezzament letterarju tal-poeżija reliġjuża ta’ Vassallo.peer-reviewe