BACKGROUND: Hyperglycemia has been associated with poor clinical outcomes in both diabetic and non-diabetic patients. The aim of this study is to determine if preoperative hemoglobin A1C level and capillary blood glucose level can be used as predictors of clinical outcomes of patients who underwent low to intermediate risk, non-cardiovascular surgical procedures. METHODOLOGY: A Single Center Cohort Retrospective Study was conducted and data were obtained from lists of patients who underwent low to intermediate risk, non-cardiovascular surgical procedures admitted for more than one day from January 2016 to December 2016. Chart review was done and provided information on demographics, presence and status of co-morbidities, availability of hemoglobin A1C ninety days prior to surgery or pre-operative capillary blood sugar, and surgical outcomes (length of hospital stay, surgical site infection, postoperative sepsis, acute renal failure or mortality). Comparison of outcomes among different levels of A1C was analyzed using Analysis of Variance and Fisher’s exact test. Comparison of outcomes between normal and elevated CBG was analyzed using independent t-test and Fisher’s exact test. The level of significance was set at 5%. RESULTS: A total of one hundred forty five patients were included in the final analysis. Of which, 69 patients had an HbA1C available within 90 days prior to surgery with the mean A1C at 8.04% ± 2.48%, and 93 patients had pre-operative capillary blood glucose with a mean value of 125.16 ± 55.94. Longer hospital stay was shown in patients with A1C level of 8-10% (4.7 ± 5.16 days). However, the association is insignificant with a P value of 0.1412. There were no significant difference in the length of hospital stay in patients with CBG level of <140mg/dL and ≥140mg/dL, with a mean value of 2.9014 ± 1.7167 days and 2.8636 ± 1.2834 days, respectively. (P = 0.9244) .There were too few events to meaningfully evaluate for secondary outcomes. CONCLUSION Our study suggests that neither preoperative capillary blood glucose level nor hemoglobin A1C is significantly associated with longer hospital stay. But the findings on patients with hemoglobin A1C values of 8.0% - 10% warrants further investigation. Providing a preoperative intervention to improve glycemic control in individuals with hemoglobin A1C values of 8.0% - 10% may improve surgical outcomes, but prospective studies are needed.

INTRODUCTION: Several electrocardiographic (ECG) criteria have previously been suggested to diagnose left ventricular hypertrophy (LVH). Studies on diagnostic performance of each criterion in Asian population were limited and this study was done to determine the diagnostic performance of the six different ECG criteria, including the newly developed Peguero–Lo Presti criterion, in diagnosing LVH in Filipino patients. METHODOLOGY: A single-center retrospective cohort study was conducted. The comparison of ECG to echocardiographic diagnosis of LVH was assessed by Spearman ρ correlation. The area under the curve analysis was used to evaluate discrimination ability of ECG-LVH criteria to identify echocardiography-LVH. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the six criteria were described with 95% confidence interval, with P < 0.05 considered statistically significant. RESULTS: A total of 325 patients were included in the final analysis; 56.61% had LVH, 23.07% of which were both ECG-based and echocardiography-based LVH. The Peguero–Lo Presti criterion had the highest sensitivity (53.1%), a lower specificity (75.5%), and a lower accuracy (68.6%), compared with the other criteria. Sokolow-Lyon index had highest specificity (97.2%) and positive predictive value (75.0%). Cornell voltage had relatively better discriminative performance (area under the curve, 0.73). CONCLUSION Having a higher sensitivity, the Peguero–Lo Presti criterion can be used as a screening tool for LVH more than the Sokolow-Lyon and Cornell voltage. Cornell voltage criterion has higher correlation with left ventricular mass index and better discriminative ability for the detection of LVH. Further studies with the possibility of combining different ECG criteria are suggested to increase the sensitivity of the ECG criteria.