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Background/Objectives: Stress-induced hyperglycemia (SIH) is frequently observed in critically ill patients and has been associated with adverse outcomes in individuals both with and without known diabetes mellitus (DM). However, evidence regarding its prognostic utility for in-hospital mortality in high-acuity emergency department (ED) populations remains limited. Methods: We conducted a retrospective observational cohort study of consecutive adult ED patients classified as Emergency Severity Index (ESI) triage level 1. SIH was defined a priori as an admission serum glucose > 140 mg/dL, a pragmatic cutoff widely applied in clinical practice despite ongoing debate regarding optimal pathophysiological thresholds. Associations with in-hospital mortality were assessed using logistic regression in the overall cohort and stratified by DM status. Additional analyses assessed the prognostic performance of admission glucose as a continuous variable. Results: Of 470 included patients, 435 had complete mortality data; 247 (56.8%) died during hospitalization. SIH was present in 258/435 (59.3%)and known DM in 114/435 (26.2%). SIH was associated with higher in-hospital mortality in univariate analysis (OR 2.90, 95% CI 1.91–4.43; p < 0.001) and remained independently associated after adjustment (adjusted OR 2.22, 95% CI 1.41–3.51; p < 0.001). The association between SIH and mortality persisted in both non-DM and DM subgroups, with no significant interaction by DM status. SIH alone showed modest discrimination for mortality (AUC 0.625, 95% CI 0.572–0.669), whereas continuous admission glucose performed better. Discrimination improved in the multivariable model (AUC 0.728, 95% CI 0.677–0.779). Restricted cubic spline analysis demonstrated a strong overall association between admission glucose and mortality without evidence of nonlinearity, indicating an approximately linear risk increase across the observed glucose range. Conclusions: Regarding severely ill ED patients, classified as ESI triage 1, SIH is an independent predictor of in-hospital mortality irrespective of DM status. Admission glucose may improve early risk stratification when incorporated into clinical models.

Background The widespread availability of antiretroviral therapy has led to improvements in life expectancy and thus an increase in the number of people living with HIV/AIDS (PLWHA) worldwide. However, a similar increase in the number of newly-diagnosed patients in Cyprus suggests the need for solutions designed to improve monitoring, planning, and patient communication. In this study, we aimed to determine whether the use of an information system to manage PLWHA might contribute to improved quality of life and critical adherence to prescribed drug regimens and ongoing medical care. Methods A randomized controlled trial study was conducted in Cyprus based on information that we collected using the highly valid and reliable Greek translation of the World Health Organization (WHO) Quality of Life (QOL) HIV-BREF questionnaire to assess sociodemographic variables and patient compliance. We distributed 200 questionnaires before implementing a Health Medical Care (HMC) information system at our clinic. Six months after implementing this system, 68 of the completed questionnaires were selected, including two groups of 34 participants who had been assigned at random to the intervention or the control group. Participants included PLWHA aged ≥ 18 years who had been receiving antiretroviral therapy for more than 12 months between July 15, 2020, and July 15, 2022. Results The changes in baseline to six-month scores reported for the intervention group were significantly higher than in the control group in all six subscales assessed with the WHOQOL-HIV-BREF questionnaire, as well as in the assessment of compliance. Furthermore, compliance with treatment was associated with higher scores in the questionnaire subscales, including physical health, psychological health, degree of autonomy, social relationships, life circumstances, and spirituality/religious/personal beliefs. We also identified specific demographic factors and behaviors that were associated with better compliance with scheduled medical care and the prescribed drug regimen. Specifically, men exhibited better compliance than women and younger PLWHA exhibited better compliance than the elderly as did individuals who reported a higher level of educational attainment. Additionally, individuals who did not use addictive substances, consumed less alcohol, and were managed using the monitoring information system all exhibited better compliance compared to those in the control group. Conclusion The results of this study suggest that management of PLWHA via the use of an information system can contribute to improved QOL and drug compliance. Plain English Summary This study was conducted to find ways to improve the lives of people living with HIV/AIDS (PLWHA) in Cyprus. With more PLWHA receiving treatment and care, it's crucial to ensure they have a good quality of life and follow their treatment plans. The main question we wanted to answer was whether using a special computer system to manage PLWHA could make their lives better and help them stick to their treatment. We found that using this computer system indeed made a positive difference. People who used it reported better physical and mental health, more independence, better relationships, and overall improved life circumstances. The study showed that managing PLWHA with a computer system can lead to better quality of life and treatment adherence. Some groups, like men, younger individuals, and those with more education, did even better. Also, people who didn't use addictive substances or consume much alcohol had better results. In summary, using technology in healthcare can greatly benefit PLWHA in Cyprus. This study highlights the importance of innovative solutions in healthcare to enhance the well-being of people living with HIV/AIDS and ensure they receive the best possible care.