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"ABSTRACT

The Factors Which Related with the Operation Delay in Central Surgery Installation at Dr.Cipto Mangunkusumo General HospitalIn accordance with scientific and technology development, surgery procedures are becoming a specialist and expensive health services.

There is a trend to minimize the cost of hospital services by establishing centralized of the high cost units such as operation rooms.

Dr. Cipto Mangunkusumo general hospital is the type A and National top referral hospital which has full array of experts/specialists physician while the tariff of the services is relatively lower than the surrounding private hospitals. The consequence of this condition, bring this hospital has to serve patients beyond its capacity which in turn overburdened the services. This condition is also affected at the central operation room, i.e. Central Surgery Installation.

In performing elective surgery procedures, the patients should wait for operation schedule. The preliminary observation showed that there were many delayed and canceled of the scheduled surgery, so that affected the hospital management and hospital performance.

The aim of this study is to know the percentage of delayed operations and affecting factors. This is a cross sectional study using observation and interviews. The sample is all of the surgery procedures during 6 working days at 12 operation rooms, in June 1996. The data was collected as primary data by filling the form and questionnaires.

The results:

1. Delayed surgery level is 90.9 %.

The delayed percentage of the arrival of consultant surgeon who needed for teaching the resident is 80.8 %, with average time of delay is 40 minutes. Then the delayed percentage of the arrival of anesthesiology resident is 60.6 % with the average time of delay is 36.6 seconds and the delayed percentage of arrival of patients is 62.1 % with the average time of delay is 4.2 minutes.

There is statistically significant correlation between the operation delay and the arrival delay of paramedic, anesthesiology resident, surgeon assistant, surgeon, surgeon consultant, the patients and the duration of operation. But there is no statistically significant correlation between the operation delay and the kind of surgery. This study is also revealed the percentage of operation cancel lance by 12.4 % with the common cause is patient subjectivity (28.6 %).

2. There are many operations which its duration are not appropriate with allocated time.

3. Lack of appropriate and adequate amount of linen, both for patients and provider, i.e. surgery linen such as jas pack, lap pack.

Suggestions :

1. Good communication between provider inside and outside of Central Surgery Installation.

2. It is necessary to make the evaluation about the report of tasks and responsibility of Central Surgery Installation and the procedure of surgery especially about the arrival of the provider.

3. It is necessary to make good cooperation with the medical committee of the hospital to take an appropriate action in case of any mistakes.

4. It is necessary to give special attention from the hospital administrator according to linen budgeting in the Central Surgery Installation.

5. It is necessary to make the longitudinal study about surgery duration according to the kind of surgery, to increase the optimal utilization of the operation room.

Bibliography : 24 ( 1969 - 1995 )

xi + 124 pages + 36 tables + 2 figures + 5 annexes;Sejalan dengan perkembangan IPTEK maka kebutuhan pelayanan kesehatan melalui tindakan bedah menjadi bentuk pelayanan kesehatan yang spesialistik, mahal.

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ABSTRAK

Terdapatnya kecenderungan penghematan biaya pada pelayanan Rumah Sakit dengan melakukan sentralisasi unit-unit yang memerlukan biaya tinggi atau unit sebagai cost center diantaranya adalah kamar operasi.

Rumah Sakit Dr. Cipto Mangunkusumo sebagai rumah sakit tipe A dan rujukan tingkat nasional mempunyai tenaga ahli yang lengkap dan tarif yang relatif murah menyebabkan pasien yang datang melebihi kapasitas dan perlu mengalami antrian yang panjang. Hal ini dapat terjadi di kamar operasi yang dikenal dengan nama Instalasi Bedah Pusat. Dalam melaksanakan tindakan operasi efektif pasien harus menunggu antrian jadwal operasi, sedangkan dari pengamatan awal didapatkan masih adanya keterlambatan atau pembatalan operasi sehingga pasien harus menunggu jadwal antrian berikutnya. Tentunya hal ini selain mempunyai dampak kepada pasien juga terhadap manajemen rumah sakit serta penampilan kerja rumah sakit.

Penelitian ini bertujuan untuk mengetahui persentase keterlambatan/pernbatalan operasi dan faktor-faktor yang mempengaruhinya. Penelitian ini merupakan studi cross sectional dengan cara pengamatan kegiatan operasi dan wawancara. Adapun sampel pada penelitian ini adalah seluruh operasi pada 12 kamar operasi selama 6 hari kerja pada bulan Juni 1996 di Instalasi Bedah Pusat RSCM. Pengumpulan data dilakukan dengan menggunakan data primer berupa formulir pengisian dan kuesioner. Analisa statistik yang dilakukan adalah analisis univariat dan bivariat.

Hasil penelitian yang didapat :

1. Tingkat keterlambatan operasi 90,9%.

Diantara anggota provider, kedatangan konsulen operator yang dibutuhkan untuk bimbingan/ujian pada 26 operasi mempunyai persentase keterlambatan sebesar 80,8% dengan rata-rata waktu keterlambatan yaitu 40 menit, diikuti keterlambatan PPDS Anestesi 60,6% dengan rata-rata waktu keterlambatan 37,6 menit. Sedangkan pasien mempunyai persentase keterlambatan 62,1% dengan rata-rata waktu keterlambatan 4,2 menit. Adanya hubungan bermakna secara statistik antara keterlambatan operasi dengan keterlambatan kedatangan paramedik, PPDS anestesi, asisten operator, operator, konsulen operator, pasien, lama operasi. Sedangkan tidak ada hubungan bermakna secara statistik antara keterlambatan operasi dengan jenis operasi. Pada penelitian ini juga terdapat pembatalan operasi sebesar 12,4%. Dimana alasan terbanyak disebabkan faktor subyektivitas pasien (28,6%).

2. Adanya lama operasi yang belum sesuai dengan alokasi waktu (rencana) yang di tentukan.

3. Kurang tersedianya linen khususnya linen pasien, linen operasional (Jas pack, Lap pack) didalam kegiatan operasi.

Saran-saran yang diusulkan antara lain :

1. Adanya hubungan komunikasi (HAM) yang baik antara anggota provider baik yang berada di bawah atau yang tidak berada di bawah Instalasi Bedah Pusat, begitu pula dengan ruang rawat yang terkait.

2. Perlunya evaluasi terhadap laporan tertulis tentang tugas/tanggung jawab IBP dan tata tertib laksana tindakan bedah khususnya mengenai kedatangan provider yang telah disetujui oleh semua pihak yang terkait.

3. Perlunya bekerja sama dengan Direktur RSCM (komite medik) untuk mengambil langkah-langkah yang dianggap perlu apabila peraturan tertulis tersebut tidak dipatuhi.

4. Perlunya perhatian administrator Rumah Sakit terhadap anggaran pengadaan linen di Instalasi Bedah Pusat.

5. Perlu diadakan suatu survai lama operasi (alokasi waktu) berdasarkan jenis operasi untuk memudahkan dalam pembuatan waktu rencana operasi, sehingga dapat meningkatkan utilisasi kamar operasi.

Daftar Pustaka : 24 (1969-1995)

xi + 124 halaman + 36 tabel + 2 gambar + 5 lampiran"

"ABSTRAK Penatalaksanaan Fistel Enterokutan masih sangat beragam dan sulit dengan tingkat kekambuhan dan kematian pasca pembedahan yang masih tinggi. Tujuan dari penatalaksanaan pasien dengan fistel enterokutan adalah koreksi defisit metabolik dan nutrisi, penutupan fistel dan mengembalikan kesinambungan saluran cerna. Tujuan dari penelitian ini adalah untuk melakukan evaluasi penatalaksanaan bedah pada fistel enterokutan yang dirawat di RSUPN Cipto Mangunkusumo selama tahun 2014-2015. Penelitian ini dirancang secara retrospektif analitik dengan mengambil data rekam medik penderita di RSUPN Cipto Mangunkusumo pada periode 2014-2015. Ditemukan 27 kasus fistel enterokutan, dimana 21 kasus yang di evaluasi, rentang umur 27-65 tahun, terbanyak pada kelompok 40-60 tahun (52,38%), letak fistel terbanyak di ileum (57,14%), high output (71,43%), gizi buruk (52,38%), dilakukan tindakan operatif (85,71%), lama rawat <20 hari (66,67%), rekurensi fistel (19,05%) dan angka kematian (14,29%).ABSTRACT Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%)."

"PendahuluanKaki Diabetik merupakan penyebab utama amputasi ekstremitas non traumatik. Pengenalan dan manajemen awal terhadap faktor-faktor predisposisi amputasi dapat mencegah tindakan amputasi.MetodeKami mengumpulkan data klinis dan laboratorium, data komplikasi-komplikasi diabetes, dan data riwayat komorbiditas pada 242 pasien yang dirawat dengan permasalahan kaki diabetik untuk menilai faktor-faktor predisposisi amputasi. Kami membagi pasien-pasien ini menjadi 2 grup (amputasi dan tidak amputasi) dan melakukan anasisis komparatif menggunakan variabel faktor-faktor predisposisi amputasi pada kedua grup.HasilDari dua buah grup dibandingkan apakah terdapat hubungan yang signifikan dengan faktorfaktor predisposisi amputasi sebagai variabel independen.Secara analisis univariat didapatkan pada grup amputasi terdapat insidens yang lebih tinggi signifikan (p<0,05) pada faktor predisposisi sepsis, ketoasidosis, neuropati perifer dan iskemia diabetik. Didapatkan odds ratio 2,57 untuk sepsis (95% CI:1,44-4,60; P=0,001); 2,67 untuk ketoasidosis (95% CI:1,16-2,58;P=0,018); 1,79 untuk iskemia diabetik (95% CI:0.970-3,37; P=0,041); dan 4,30 untuk neuropati perifer (95% CI:0.95-19,2; P=0,030).KesimpulanSepsis, ketoasidosis, neuropati perifer dan iskemia diabetik merupakan faktor-faktor predisposisi amputasi yang signifikan pada pasien-pasien kaki diabetik.

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Introduction

Diabetic foot is the main cause of nontraumatic lower extremity amputation. Early recognition and management of predisposing factors for amputation may prevent amputations.

Method

We collected clinical and laboratory data, details of diabetes complications and history of comorbidities in 242 patients who were admitted for management of diabetic foot to determine the predisposing factors of amputation in these patients. We devided these patients into two groups, those whose treatment included amputation and those who were treated conservatively

and carried out a comparative analysis of the variables in the two groups.

Result

From the two groups we compared if there is significant relationship with the predisposing factors for amputation as independent variable. In univariat analysis we found higher incidence (p<0,05) of sepsis, ketoacidosis, peripheral neuropathy and diabetic ischemia on amputated group. Univariat adjusted odds ratios was 2,57 for sepsis (95% CI:1,44-4,60; P=0,001); 2,67 for

ketoacidosis (95% CI:1,16-2,58; P=0,018); 1,79 for diabetic ischemia (95% CI:0.970-3,37; P=0,041); and 4,30 for peripheral neuropathy (95% CI:0.95-19,2; P=0,030).

Conclusion

Sepsis, ketoacidosis, peripheral neuropathy and diabetic ischemia are significant predisposingfactors for amputation in patients hospitalized for diabetic foot lesions."

"[ABSTRAKLatar belakang: Luaran pasca-bedah jantung penting diketahui untuk menilai kinerja pelayanan bedah jantung anak, sehingga kualitas pelayanan dapat ditingkatkan.Tujuan: Mengetahui luaran jangka pendek (mortalitas, komplikasi pasca-bedah berat lain, dan komplikasi pasca-bedah yang berat) pada anak yang dilakukan bedah jantung. Selain itu, ingin mengetahui faktor risiko terjadinya komplikasi berat pasca-bedah jantung dan membuat sistem skor dari faktor-faktor risiko tersebut.Metode: Setiap anak dengan penyakit jantung yang dilakukan operasi jantung di RSUPN Dr Cipto Mangunkusumo Jakarta sejak April 2014 sampai Maret 2015 diikuti setiap hari sampai pasien pulang atau meninggal. Data demografis, mortalitas, morbiditas atau komplikasi pasca-bedah jantung, dan faktor risiko terjadinya morbiditas pasca-operasi yang berat diambil dari rekam medis. Pasien yang sudah pulang dari rumah sakit, dalam waktu 30 hari pasca-operasi dihubungi untuk mendapatkan data kondisi pasien dalam waktu tersebut (hidup atau meninggal).Hasil: Selama penelitian didapatkan 258 anak dilakukan bedah jantung. PJB terbanyak yang dilakukan bedah jantung adalah ventricle septal defect (28,7%) dan tetralogy of Fallot (24,4%). Komplikasi pasca-bedah jantung terjadi pada 217 (84,1%) anak dan komplikasi berat terjadi pada 49 anak (19%). Komplikasi pasca-bedah jantung terbanyak adalah hipokalsemia pada 163 (63,2%) anak, hiperglikemia 159 (61,6%), low cardiac output syndrome 52 (20,2%), aritmia 48 (18,6%), sepsis 45 (17,4%), dan efusi pleura 39 (15,1%). Komplikasi berat meliputi in-hospital mortality terjadi pada 33 (12,7%) anak dan mortalitas dalam waktu 30 hari pasca-bedah jantung terjadi pada 35 (13,6%) anak, henti jantung 13 (5%), operasi jantung ulang 10 (3,9%), dan gagal organ multipel 19 (7,4%). Faktor risiko yang berhubungan dengan meningkatnya komplikasi pasca-bedah jantung yang berat adalah peningkatan kadar laktat darah [OR 30,7 (IK 95% 8,1-117,6)], PJB sianotik [OR 4,4 (IK 95% 1,2-15,8), dan pemakaian inotropik yang tinggi [OR 7,8 (IK 95% 1,6-38,9)]. Skor faktor risiko ≥ 3 mampu memprediksi anak yang mengalami komplikasi berat pasca-bedah jantung dengan sensitivitas skor 93,9% dan spesifisitas skor 84,2%, dan area di bawah kurva receiver operating characteristic (ROC) adalah 0,94.Simpulan: Mortalitas di rumah sakit pasca-bedah jantung anak sebesar 12,7% dan mortalitas 30 hari pasca-bedah 13,6%. Komplikasi berat lain pasca-bedah 13,6%. Faktor risiko yang berhubungan dengan meningkatnya komplikasi pasca-bedah jantung yang berat adalah peningkatan kadar laktat darah, PJB sianotik, dan pemakaian inotropik tinggi pasca-bedah jantung. Skor faktor risiko ≥ 3 mampu memprediksi anak yang mengalami komplikasi berat pasca-bedah jantung dengan sensitivitas skor 93,9% dan spesifisitas skor 84,2%.

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ABSTRACTBackground: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%.;Background: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%., Background: Outcome of children with cardiac surgery is important to evaluate the performance of cardiac surgery program. Identifying the risk factors for major adverse events after cardiac surgery is also important to improve patient care.Objective: To evaluate the incidence of short-term outcome in children after cardiac surgery, including mortality, complication or morbidity, major complications, and the risk factors associated with major adverse events (major complications) at the Dr Cipto Mangunkusumo Hospital, Indonesia.Methods: A prospective observational study was conducted from April 2014 until March 2015. All children conducted cardiac surgery, were monitored from the time the cardiac surgery performed until patients were discharged or deceased. During the follow up of all recruited patients, factors associated with the risk of developing major adverse events were identified.Results: A total of 258 patients were recruited during the study period. Of the total, 134 (51.9%) were female. The mean age of the patients was 53.3±3.8 months. Among the patients, 217 (84.1%) had complications. The most complications occurred after cardiac surgery were hypocalcaemia in 163 (63.2%), hyperglycemia in 159 (61.6%), low cardiac output syndrome in 52 (20.2%), arrhythmia in 48 (18.6%), sepsis in 45 (17.4%), and pleural effusion in 39 (15.1%) children. Further, 49 (19%) of recruited patients had major adverse events (major complications), including in-hospital mortality in 33 (12.7%) and 30-day mortality in 35 (13.6%), cardiac arrest in 13 (5%), the need for re-operation in 10 (3.9%), and multiple organ failure in 19 (7.4%) children. Factors associated with the occurrence of major complications were increase in blood lactate [OR 30.7 (95% CI 8.1-117.6)], cyanotic congenital heart disease [OR 4.4 (95% CI 1.2-15.8), and high inotropes on leaving operating room [OR 7.8 (95% CI 1.6-38.9)]. Risk factor score ≥3 could predict major complications after cardiac surgery with sensitivity of 93.9% and specificity of 84.2%, and area under receiver operating characteristic (ROC) curve was 0.94.Conclusion: In-hospital mortality after paediatric cardiac surgery at Dr Cipto Mangunkusumo hospital is 12,7% and 30-day mortality is 13,6%. Increase in blood lactate, cyanotic congenital heart disease, and high inotropes on leaving operating room are associated with mortality and other major complications in children following cardiac surgery. Risk score ≥ 3 can predict the development of major complication in children after cardiac surgery with sensitivity 93,9% and specificity 84,2%.]"

"Infeksi kaki diabetik adalah faktor predisposisi utama amputasi ekstremitas bawah pada penyebab non trauma. Namun baru sedikit studi yang menyelidiki faktor - faktor risiko spesifik. Metode penelitian studi kohort retrospektif sampel besar dengan melakukan observasi data rekam medik 201 pasien dengan diagnosis infeksi kaki diabetic di RS Dr. Cipto Mangunkusumo antara tahun 2008 hingga tahun 2010. Faktor - faktor risiko kami lakukan analisis univariat, bivariat serta multivariat kemudian dilakukan model regresi logistik dan mengkonversi koefisien model ke risk score numerik. Pada hasil sebanyak 25.7% menjalani amputasi ekstremitas bawah diperoleh persamaan dengan kalibrasi Hosmer and Lemeshow Test yang baik dan nilai AUC adalah sebesar 82%. Penelitian pendahuluan ini menghasilkan sistem skoring yang sederhana dan mudah digunakan untuk mengetahui risiko amputasi ekstremitas bawah pada pasien yang menderita infeksi kaki diabetik.

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Diabetic foot infection is the primary predisposition for lower extremity amputation in non-trauma etiology. There were only few studies that has determined specific risk factors. This pilot study methods used large sample retrospective cohort study by observing 201 medical records of patients with diabetic foot infection diagnosis in Cipto Mangunkusumo Hospital for 2008 to 2010. We did univariate, bivariate, multivariate analysis continue with logistic regression model and converting coefficient model to numeric risk score. Result, there were 27.7% had lower extremity amputation, logistic regression with good equation result on Hosmer and Lemeshow test and AUC score were 82%. This pilot study produce a simple scoring system and easy to use to identify lower extremity amputation risks on diabetic foot infection patient."

"Pembatalan operasi elektif di RSUP Dokter Kariadi, sebesar 6,49% di atas angka standar tahun 2012 ( ≤ 5% ). Pembatalan operasi elektif dapat menyebabkan ketidakpuasan pasien, peningkatan biaya, lama rawat pasien di rumah sakit, dan mencerminkan inefisiensi. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan pembatalan operasi elektif. Sebanyak 6,8 % operasi elektif dibatalkan karena alasan medis 106 (46,1%) dan non medis 124 (53,9%). Pembatalan operasi berhubungan dengan kondisi pasien, hasil laboratorium tidak normal, dan kesiapan operator. Sehingga disarankan untuk dikembangkan klinik pra bedah.

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Cancellation of elective surgery at Doctors Hospital Kariadi, amounting to 6.49% is still above the standard ( ≤ 5% ). Cancellation of elective surgery could lead to patient dissatisfaction, increased costs, length of stay and reflects the inefficiency. This study aims to determine the factors associated with the cancellation of elective surgery. 6.8 % elective operations were canceled due to medical reasons (46.1%) and non-medical (53.9%). Cancellation of operations related to the patient's condition, abnormal laboratory results, and operator. It is suggested to develop pre ? surgery clinic."