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"Latar belakang: Corona Virus Disease 19 (COVID-19) merupakan sebuah kumpulan gejala permasalahan saluran napas atas yang disebabkan olehh virus SARS-CoV-2. Penyakit ini telah menjadi permasalahan global, dan diketahui bahwa populasi lanjut usia memiliki risiko jangkitan dan mortalitas yang tinggi. Prevalensi mortalitas pasien COVID-19 lanjut usia adalah 49,9%. Angka ini sangatlah tinggi karena pasien lanjut usia memiliki faktor risiko yang lebih banyak dibandingkan populasi dewasa, faktor risiko tersebut adalah usia, komorbiditas, dan adanya perubahan fungsi tubuh. Salah satu faktor risiko yang penting untuk dipertimbangkan dalam menilai prognosis adalah status nutrisi pasien. Disebutkan bahwa pasien lanjut usia memiliki prevalensi risiko malnutrisi yang tinggi yaitu berkisar antara 18-78%. Oleh karena itulah penelitian memiliki tujuan untuk melihat hubungan status nutrisi dengan mortalitas pasien COVID-19 berusia lanjut.Metode: Penelitian ini menggunakan desain studi kohort retrospektif dengan menggunakan data sekunder berupa rekam medis pasien Rumah Sakit Cipto Mangungkusumo.Hasil: Total subjek penelitian berjumlah 459 orang dengan pasien berusia 60-69 tahun sebanyak 302 orang (65,7%) dan pasien berusia ≥70 tahun sebanyak 157 orang (34,2%). Rata-rata usia subjek penelitian adalah 67,78 ± 6,9 tahun dengan median 66 tahun. Jenis kelamin subjek yang paling mendominasi adalah laki-laki dengan jumlah 279 orang (60,8%). Sebanyak 177 orang (38,6%) dinyatakan berisiko malnutrisi menggunakan asesmen malnutrition screening tool (MST). Angka mortalitas dalam perawatan pasien COVID-19 berusia lanjut adalah 28,3%. Pada analisis bivariat, didapatkan bahwa malnutrisi memiliki hubungan yang signifikan pada mortalitas pasien COVID-19 berusia lanjut dengan relative risk 2,63 (95% CI: 2,603-6,273; p = 0,000).Kesimpulan: Malnutrisi meningkatkan risiko mortalitas pasien COVID-19 berusia lanjut.

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Introduction: Corona Virus Disease 19 (COVID-19) is a disease that is caused by SARS-CoV-2 and can be identified by several respiratory symptoms. This disease has been a global threat in every country, and it is known that elderly population have the greatest risk of infection and mortality. The mortality prevalence of eldery patients infected by COVID-19 in Indonesia is 49,9%. The prevalence is so high because elderly patient carries a lot of risk factors, such as age itself, comorbidities, and functional body change. One of the risk factors that we need to consider to be prognostic factors is nutrition status. Malnutrition prevalence in elderly patients is estimated to be 18-78%. With that in mind, this research is intended to look at the effect of nutrition status on mortality in COVID-19 elderly patients.     

Method: This research is using retrospective cohort as its study design. We used secondary data from the Rumah Sakit Cipto Mangunkusumo patient’s medical records.

Result: There are 459 research subjects with 302 people (65,7%) in the 60-69 years old age population and 157 remaining people (34,2%) in ≥ 70 years old age population. The mean age in this study was 67,78 ± 6,9 years old with the median of 66 years old. This study population was dominated by males group of 279 people (60,8%). A total of 177 people was diagnosed with risk of malnutrition by malnutrition screening tool (MST) assessment. In-hospital mortality occurred for 28,3% from total sample population.  Bivariat analysis showed that malnutrition has a significant relationship with mortality in COVID-19 elderly patients with a relative risk of 2,63 (95% CI: 2,603-6,273; p = 0,000).

Conclusion: Malnutrition increased the mortality risk for COVID-19 elderly patients."

"Covid-19 (Coronavirus Disease-2019) adalah penyakit yang disebabkan oleh virus SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2). Usia tua (≥65 tahun), jenis kelamin laki-laki, hipertensi, penyakit kardiovaskular, diabetes, PPOK dan kanker dapat meningkatkan risiko kematian akibat Covid-19. Desain penelitian ini adalah studi analitik kasus kontrol dari data penelusuran epidemiologi (PE) Dinas Kesehatan Kota Tangerang Selatan sejak bulan Maret 2020-Juli 2021. Jumlah sampel kelompok kasus dan kontrol masing-masing sebanyak 344 sehingga total sampel adalah 688 sampel. Proporsi pasien Covid-19 yang memiliki diabetes mellitus (DM) pada kelompok kasus adalah 35% dan pada kelompok kontrol sebanyak 4%. Analisis bivariat hubungan diabetes mellitus dengan mortalitas pasien Covid-19 di Tangerang Selatan menunjukkan OR=12.47 (p-value=0.0000; 95% CI 6.9-24). Analisis multivariat dengan regresi logistik dihasilkan OR=15.87 (p-value=0.000; 95% CI 7.09-35.5) setelah dikontrol dengan usia, hipertensi, interaksi DM dengan hipertensi, dan interaksi DM dengan gangguan imunologi.

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Covid-19 (Coronavirus Disease-2019) is a new disease caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2). Old age (≥65 years old), male, hypertension, cardiovascular disease, diabetes, COPD, and cancer are associated with higher mortality risk. The design of this study is case control using secondary data penelusuran epidemiologi (PE) of Dinas Kesehatan Kota Tangerang Selatan since March 2020-July 2021. The sample size from each case and control was 344 so the total sample was 688 sample. Proportion of Covid-19 patients with diabetes mellitus (DM) is 44.77% in case group and 8.14% in control group. Bivariate analysis of the association of diabetes mellitus with mortality among Covid-19 patients in South Tangerang showed OR=12.47 (p-value=0.0000; 95% CI 6.9-24). Multivariate analysis using logistic regression showed OR=15.87 (p-value=0.000; 95% CI 7.09-35.5) after age, hypertension, interaction between DM and hypertension, and interaction between DM and autoimmune disease were controlled."

"Latar Belakang: COVID-19 menyebabkan penyakit kritis dan kematian dengan manifestasi utama sindrom pernafasan akut. Prediktor kematian pada kasus COVID-19, seperti IL-6 berperan dalam mengatur respon imun dan inflamasi. Pada kasus berat, peningkatan IL-6 dapat menyebabkan sepsis dan kegagalan multi-organ. CRP juga berkontribusi signifikan terhadap peradangan. Keparahan derajat COVID-19 dipengaruhi oleh komorbiditas seperti penyakit kardiovaskular, diabetes melitus tipe II, dan hipertensi. Tocilizumab, penghambat reseptor IL-6 merupakan terapi baru untuk pasien COVID-19 berat dan kritis. Penelitian ini menilai mortalitas pasien COVID-19 berat yang diberikan dan tidak diberikan terapi tocilizumab setelah dikontrol oleh variabel perancu. Tujuan: Menganalisis pengaruh terapi tocilizumab terhadap kematian pada pasien COVID-19 berat. Metode: Desain penelitian kohort retrospektif, menggunakan data rekam medis pasien COVID-19 di ICU RSCM selama dua tahun. Data dianalisis menggunakan SPSS. Hasil: Total 80 subjek, 52 pasien meninggal dan 28 pasien hidup. Mayoritas pasien memiliki CRP tinggi, IL-6 meningkat, serta tidak memiliki komorbid hipertensi, diabetes mellitus tipe II, dan penyakit kardiovaskular. Analisis statistik menunjukkan tidak ada hubungan yang signifikan antara pemberian terapi tocilizumab dan kematian, serta tidak terdapat perancu dalam penelitian ini. Kesimpulan: Pemberian terapi tocilizumab tidak memperbaiki kejadian mortalitas pada pasien COVID-19 berat.

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Background: COVID-19 causes critical illness and death with the main manifestation of acute respiratory syndrome. Predictors of death in COVID-19 cases, such as IL-6, play a role in regulating the immune response and inflammation. In severe cases, increased IL-6 can cause sepsis and multi-organ failure. CRP also contributes significantly to inflammation. The severity of COVID-19 is influenced by comorbidities such as cardiovascular disease, type II diabetes mellitus, and hypertension. Tocilizumab, an IL-6 receptor inhibitor, is a new therapy for severe and critical COVID-19 patients. This study assessed the mortality of severe COVID-19 patients who were and were not given tocilizumab therapy after controlling for confounding variables. Objective: To analyze the effect of tocilizumab therapy on mortality in severe COVID-19 patients. Methods: Retrospective cohort study design, using medical record data of COVID-19 patients in the ICU RSCM for two years. Data were analyzed using SPSS. Results: A total of 80 subjects, 52 patients died and 28 patients survived. The majority of patients had high CRP, increased IL-6, and did not have comorbid hypertension, type II diabetes mellitus, and cardiovascular disease. Statistical analysis showed no significant association between tocilizumab therapy and mortality, and there were no confounders in this study. Conclusion: Administration of tocilizumab therapy does not reducing mortality rates in severe COVID-19 patients."

"Latar Belakang: Pengobatan Kanker kepala leher (KKL) melalui terapi radiasi maupun kemoradiasi sering menimbulkan efek samping. Efek samping terapi radiasi pasien KKL menyebabkan gangguan asupan yang meningkatkan kejadian malnutrisi. Ketersediaan jalur nutrisi enteral merupakan salah satu tata laksana nutrisi yang dapat diberikan untuk mencegah penurunan asupan dan status gizi pasien KKL. Penelitian ini bertujuan melihat korelasi antara ketersediaan jalur nutrisi enteral dengan pemenuhan nutrisi dan status gizi.Metode: Studi potong lintang dilakukan pada subjek dewasa dengan KKL pasca terapi radiasi di poliklinik radioterapi RSCM. Pemenuhan nutrisi dinilai dengan FFQ semi kuantitatif sedangkan status gizi diukur dengan menghitung indeks massa tubuh (IMT). Ketersediaan jalur nutrisi enteral didapatkan melalui wawancara dan rekam medis pasien.Hasil: Sebanyak 41 subjek penelitian dengan rerata usia 51 tahun ikut serta dalam penelitian. Sebagian besar subjek adalah laki-laki, diagnosis kanker nasofaring, stadium IV, dan jalur nutrisi oral. Rerata IMT subjek 20,5 ± 3,6 kg/m2 dan rerata asupan subjek 1336,7 ± 405,5 kkal/hari. Rerata IMT subjek dengan jalur nutrisi enteral lebih rendah dibandingkan dengan jalur nutrisi oral yaitu 18,2 ± 2,6 kg/m2 dibanding 21,2 ± 3,5 kg/m2. Rerata total asupan energi subjek dengan jalur nutrisi enteral lebih tinggi dibandingkan dengan jalur nutrisi oral yaitu 1498,1 ± 430,6 kkal/hari dibanding 1291,4 ± 393,3 kkal/hari. Terdapat korelasi nagatif sedang antara ketersediaan jalur nutrisi enteral dengan status gizi (r=-0,346, p=0,027) dan korelasi positif lemah dengan pemenuhan nutrisi (r=0,216, p=0,174). Meskipun demikian pada penelitian ini ditemukan bahwa proporsi subjek yang mendapat jalur nutrisi enteral dan mengalami penurunan IMT lebih sedikit dibandingkan dengan proporsi subjek yang menggunakan jalur oral, yaitu 22,2% dengan 43,8%.Kesimpulan: Terdapat korelasi negatif sedang yang signifikan antara ketersediaan jalur nutrisi enteral dengan status gizi dan korelasi positif lemah dengan pemenuhan nutrisi yang masih dipengaruhi oleh faktor perancu penelitian.

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Background: Treatment of head and neck cancer (HNC) through radiation therapy or chemoradiation often lead to side effects. The side effect of radiation therapy in HNC patients might deteriorate food intake that increase the incidence of malnutrition. The availability of enteral nutrition is one of nutritional interventions that can be provided to prevent detrimental of food intake and nutritional status in HNC patients. This study aims to evaluate the correlation between the availability of enteral nutrition with nutritional fulfillment and nutritional status.

Method: A cross sectional study was conducted on adult HNC patients after radiation therapy at Radiotherapy Outpatient Clinic of Dr. Cipto Mangunkusumo Hospital. Nutritional fulfillment was assessed by semi-quantitative food frequency questionnaire (FFQ) while nutritional status was measured by calculating body mass index (BMI). The availability of enteral route was obtained through interviews and patients medical records.

Results: A total of 41 subjects with a mean age of 51 years participated in the study. Most of the subjects were male, with stage IV nasopharyngeal cancer and oral nutrition route. The mean of BMI was 20,5 ± 3,6 kg/m2 and the mean food intake was 1336,7 ± 405,5 kcal/day. The mean BMI of subjects with enteral nutrition was lower than those on oral nutrition, which was 18,2 ± 2,6 kg/m2 compared to 21,2 ± 3,5 kg/m2. The mean total energy intake of subjects with enteral nutrition route was higher than oral nutrition route, which was 1498,1 ± 430,6 kcal/day compared to 1291,4 ± 393,3 kcal/day. There was a moderate negative correlation between the availability of enteral nutrition and nutritional status (r=-0,346, p=0,027), meanwhile there was a weak positive correlation with nutritional fulfillment (r=0,216, p=0,174). However, in this study we found that the proportion of subjects with enteral nutrition who experienced a decrease of BMI was less than the proportion of subjects on the oral route, which was 22,2% compared to 43,8%, respectively.

Conclusion: There is a moderate negative correlation between the availability of enteral nutrition which was statistically significant with nutritional status and a weak correlation with nutritional fulfillment which was still influenced by confounding factors."

"Latar belakang: Pada pertengahan tahun 2021, Indonesia mengalami lonjakan kasus COVID-19 dengan infeksi berat yang berdampak pada peningkatan jumlah kematian. Hipertensi diketahui menjadi salah satu penyakit penyerta yang paling banyak dimiliki oleh pasien COVID-19. Tujuan dari penelitian ini adalah untuk melihat pengaruh hipertensi secara independen terhadap mortalitas COVID-19 di RSUD Pasar Minggu periode tahun 2021. Metode: Penelitian ini menggunakan desain kohort retrospektif dengan data yang digunakan berasal dari rekam medis pasien yang terkonfirmasi positif COVID-19. Sampel terpilih dengan metode simple random sampling dan analisis yang digunakan adalah analisis survival Kaplan-meier dan analisis multivariat Cox proportional-hazards regression. Hasil: Hasil yang didapatkan yaitu probabilitas kumulatif survival pasien dengan hipertensi lebih rendah dibandingkan dengan pasien tanpa hipertensi (50,6% dengan 62,7%, log-rank test=0,007). Selain itu, hipertensi secara independen meningkatkan risiko mortalitas pada pasien COVID-19 yang dirawat inap di RSUD Pasar Minggu periode tahun 2021 (aHR=1,721; 95% CI 1,109-2,677; p-value 0,015). Kesimpulan: Dengan demikian, seiring dengan perjalanan waktu pandemi COVID-19 ini diharapkan rumah sakit dapat tetap melakukan pemantauan yang lebih ketat terhadap pasien dengan komorbiditas terutama hipertensi sehingga dapat terus menurunkan angka kematian akibat COVID-19.

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Introduction: In Mid-2021, Indonesia encountered a surge of severe cases of COVID-19 resulting in an increased number of death. Hypertension is well-known as one of the most common comorbidities in COVID-19 patients. This study aims to examine the impact of hypertension independently on COVID-19 mortality at Pasar Minggu Hospital in 2021.

Method: This study used a retrospective cohort design from the medical records of confirmed cases of COVID-19. The sample was selected using simple random sampling, analyzed using Kaplan-meier survival analysis and cox proportional-hazards regression analysis.

Results: The result of this study found that the cumulative probability survival of COVID-19 patient’s with hypertension was lower than without hypertension (50.6% vs 62.7%, log-rank test=0.007). In addition, hypertension independently increased the risk of mortality in COVID-19 patients hospitalized at Pasar Minggu Hospital throughout 2021 (aHR = 1.721; 95% CI 1,109-2,677; p-value 0,015).

Conclusion: Thus, along with the passage of time for the COVID-19 pandemic, we hoped that health-care provider would continue to treat patients with hypertension and other comorbidities firmly in order to reduce the COVID-19 mortality rate."

"ABSTRAKProses penuaan memberi dampak pada fungsi tubuh manusia, salah satunya adalah sarcopenia. Sarcopenia adalah pengurangan keseluruhan massa otot skeletal dan kekuatan secara progresif. Kondisi ini bisa berkembang menjadi lemah. Frailty akan menyebabkan perubahan keseimbangan energi yang malnutrisi. Pengurangan status Gizi biasanya ditemukan pada pasien usia lanjut. Jika tidak dirawat dengan benar, negara bisa progresif. Selain itu, kekuatan genggaman tangan yang dikenal memiliki beberapa kaitan dengan beberapa kondisi pada lansia seperti sarkopenia dan kerapuhan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara kekuatan genggaman tangan dan status gizi. Penelitian ini menggunakan rancangan cross sectional yang dilakukan di Poliklinik Geriatrik Rumah Sakit Cipto Mangunkusumo untuk pasien geriatri antara Januari September 2016. Kekuatan genggaman tangan dan status gizi diukur menggunakan Jamar Dynamometer dan Mini Nutritional Assessment. Dari 98 pasien, median kekuatan genggaman tangan adalah 18. Ada 6 pasien 6,1 dengan malnutrisi dan 59 pasien 60,2 dengan risiko kekurangan gizi dan 33 pasien 33,7 dengan status gizi normal. Berdasarkan uji korelasi Pearson, kekuatan genggaman tangan berhubungan dengan status gizi p 0,008 dan r 0,268. Kesimpulan dari penelitian ini adalah kekuatan genggaman tangan berhubungan dengan status gizi.

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ABSTRAKProcess of aging give some impact to function of human body, one of them is sarcopenia. Sarcopenia is overall reduction of skeletal muscle mass and power progressively. This condition can develop become frailty. Frailty will lead to change of energy balance which is malnutrition. Reduction of Nutritional status is commonly found in elderly patient. If it is not treated properly, the state can be progressive. Besides, hand grip strength well known has some association to several condition in elderly such as sarcopenia and frailty. The aim of this research is to find the correlation between hand grip strength and nutritional status. This research using cross sectional design was conducted in Geriatric Policlinic of Cipto Mangunkusumo Hospital to geriatric patients between January September 2016. Hand grip strength and nutritional status was measured using Jamar Dynamometer and Mini Nutritional Assessment. From 98 patients, the median of hand grip strength was 18. There were 6 patients 6,1 with malnutrition and 59 patients 60,2 with risk of malnutrition and 33 patients 33,7 with normal nutritional status. Based on Pearson correlation test, hand grip strength has correlation with nutritional status p 0,008 and r 0,268 . The conclusion of this research is hand grip strength has correlation with nutritional status."

"Objektif: Pengurangan pada jumlah gigi posterior dapat dihubungkan dengan asupan nutrisi, status nutrisi, dan kemampuan mastikasi pada lansia. Penelitian sebelumnya mengenai hubungan antara kehilangan gigi, asupan nutrisi, status nutrisi, dan kemampuan mastikasi. Metode: Total 158 subjek berusia diatas 60 tahun di kota Depok, Jawa Barat, Indonesia. Gigi posterior dibagi menjadi 2 grup berdasarkan Index Eichner; grup A2-B3 dan grup B4-C3. Untuk pengukuran asupan nutrisi dilakukan menggunakan semi-quantitative food-frequency questionnaire dengan mengukur jumlah kalori, dan untuk mengukur status nutrisi menggunakan Mini-Nutritional Assessment-Short Form. Hasil: 74% subjek perempuan, 26% laki-laki. Terdapat perbedaan signifikan pada nilai rata-rata kemampuan mastikasi (p = 0.000), Eichner grup A2-B3 (5.66 ± 1.80) dan B4-3 (3.20 ± 1.25). Namun, tidak ada perbedaan signifikan antara status nutrisi dan asupan nutrisi pada kedua grup Eichner. Kesimpulan: Hasil penelitian ini menyatakan bahwa kehilangan gigi berhubungan dengan kemampuan mastikasi, namun tidak pada status nutrisi ataupun asupan nutrisi pada lansia.

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Objective: A reduction in the number of posterior teeth is associated with diminished nutrition intake, nutritional status, and masticatory performance in the elderly. Previous studies on the relationships between tooth loss, nutrition intake, nutritional status, and masticatory performance have yield varying results. Methods: A total of 158 subjects aged 60 years and older from Depok, West Java, Indonesia were enrolled in the study. Posterior tooth contacts were assessed based, and the subjects were accordingly divided into two groups based on the Eichner Index; group A2-B3 and group B4-C3. A semi-quantitative food-frequency questionnaire was used to measure nutritional intake in the form of total calories, and the Mini-Nutritional Assessment-Short Form was used to measure nutritional status. Results: Seventy-four percent of participants were females, and the remaining (26%) were males. A significant difference in the mean masticatory performance score (p = 0.000) was noted between Eichner group A2-B3 (5.66 ± 1.80) and B4-C3 (3.20 ± 1.25). However, no statistically significant differences in nutritional status and calorie intake were noted between the two groups. Conclusion: These findings indicate that the number of teeth lost is related to mastication, but not to nutritional status or calorie intake in the elderly."

"Latar Belakang: Kehilangan gigi dapat menyebabkan terganggunya fungsi mastikasi sehingga dapat mempengaruhi status nutrisi pralansia dan lansia. Pemakaian gigi tiruan dapat mengembalikan fungsi gigi yang hilang sehingga diharapkan dapat meningkatkan status nutrisi. Keberhasilan perawatan gigi tiruan selain dipengaruhi oleh penilaian dokter gigi juga dipengaruhi oleh penilaian pasien. Penilaian dari pasien diukur oleh tingkat kepuasaan pasien. Faktor yang mempengaruhi kepuasaan pasien diantaranya adalah fungsi mastikasi yang berpengaruh pada status nutrisi pasien. Tujuan: Menganalisis hubungan kepuasan pemakaian gigi tiruan lepasan menggunakan kuesioner Turker’s patient’s perceptions-ID dengan status nutrisi menggunakan kuesioner Mini Nutritional Assessment- Short Form (MNA-SF) pada pralansia dan lansia. Menganalisis pengaruh faktor usia, jenis kelamin, tingkat pendidikan, jenis gigi tiruan lepasan, klasifikasi Eichner, dan lama pemakaian gigi tiruan lepasan terhadap tingkat kepuasan pemakai gigi tiruan dan status nutrisi. Metode: 88 subjek (27 laki-laki dan 61 perempuan) berusia 45 tahun ke atas berpartisipasi dalam penelitian ini. Dilakukan pencatatan data diri subjek, pemeriksaan rongga mulut, pengukuran berat dan tinggi badan, serta wawancara kuesioner Turker’s patient’s perceptions-ID dan MNA-SF. Hasil penelitian: Tingkat kepuasan pemakai gigi tiruan lepasan memiliki hubungan bermakna dengan status nutrisi pada pralansia dan lansia (p < 0,05). Kepuasan pasien dan status nutrisi memiliki hubungan bermakna dengan usia, tingkat pendidikan, jenis gigi tiruan lepasan dan klasifikasi Eichner. Kesimpulan: Semakin tinggi tingkat kepuasan pasien terhadap gigi tiruan lepasanya maka akan semakin baik tingkat status nutrisinya.

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Background: Tooth loss can cause disruption of mastication and may affect the nutritional status of pre-elderly and elderly. Denture wearing can improve tooth function so it may improve patient’s nutrition. The success of denture treatment is not only influenced by the assessment of the dentist but also influenced by the assessment of the patient. Patient assessment is measured by the level of patient satisfaction. Mastication is one of factors that influence patient satisfaction which can affects patients nutritional status.

Objective: The aim of this study is to analyze the relationship between satisfaction of removable denture using the Turker's patient's perceptions-ID questionnaire and nutritional status using the MNA-SF questionnaire in the elderly, and analyze the influence of age, gender, education level, type of removable denture, Eichner classification, duration of using removable dentures to denture satisfaction level and nutritional status.

Method: 88 subjects (27 male and 61 female) aged 45 years and older were included in the study. Subjects personal data, oral examination, weight and height measurement were obtained, and interview for Turker’s patient’s perceptions-ID and MNA-SF were conducted.

Results: The level of satisfaction of removable denture users had a significant relationship with nutritional status in elderly (p <0.05). Patient satisfaction and nutritional status have a significant relationship with age, level of education, type of removable denture and tooth loss based on Eichner's classification.

Conclusion: The better level of patient satisfaction with their removable dentures, the better their nutritional status is."

"Seluruh aspek kehidupan telah dipengaruhi oleh pandemi COVID-19 termasuk bidang kesehatan. Disisi lain, terdapat peningkatan jumlah penderita kanker setiap tahunannya. Hubungan karakteristik klinis kanker ginekologi dengan infeksi COVID-19 terhadap mortalitas belum banyak diteliti. Dalam penelitian ini digunakan metode retrospective cross-sectional yang menggunakan data pasien penderita kanker ginekologi dengan infeksi COVID-19 yang terdaftar pada Departemen Obstetri Ginekologi RSPUN Dr. Cipto Mangunkusumo pada tahun 2020-2022. Penelitian ini menggunakan analisis uji Chi Square untuk menentukan variable yang akan dimasukan kedalam analisis regresi logistik backward stepwise. Dalam penelitian ini ditemukan usia >59 (OR, 0.020; Cl 95% 0.001-0.577; P= 0.023), anemia(OR,0.053; Cl 95% 0.005-0.565; P= 0.015), ARDS (OR, 50,010; CL 95%, 1,145-2185.101; P = 0.042), Hyperkalemia (OR, 11,189; Cl 95% 1,491-83.992; P = 0.019), Sepsis (OR, 18,386; Cl 95% 2,220-152.253; P= 0.007), ECOG >2 (OR, 12.859; Cl 95% 2.582-64.020; P= 0.002), and Degree of Severe-Critical COVID-19 (OR, 111.310; Cl 95% 3.961-3128.117; P= 0.006). Dapat disimpulkan ARDS, hyperkalemia, sepsis, ECOG >2, dan derajat COVID-19 berat-kritis memiliki signifikansi baik terhadap statistik maupun klinis dengan mortalitas, namun usia > 59 dan anemia secara klinis tidak memiliki signifikansi.

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All aspects of life have been affected by the COVID-19 pandemic, including the health sector. On the other hand, the number of cancer patients is continuously increasing every year. The relationship between clinical characteristics of gynecological cancer with COVID-19 infection and mortality has not been widely studied. This study used a retrospective cross-sectional method using data on patients with gynecological cancer with COVID-19 infection registered in the gynecology department of Dr. Cipto Mangunkusumo Hospital in 2020-2022. This study used chi-squared test analysis to determine the variables to be included in backward stepwise logistic regression analysis. In this study, it was found that age >59 (OR, 0.020; Cl 95% 0.001-0.577; P = 0.023), anemia (OR, 0.020; Cl 95% 0.001-0.578; p= 0.023), ARDS (OR, 48.796;  Cl 95%, 1.131-2105.921; P=0.043), hyperkalemia (OR, 10.960; Cl 95% 1.462-82.187; p= 0.020), sepsis (OR, 18.087; Cl 95% 2.192-149.271; P= 0.007), ECOG >2 (OR, 12.629; Cl 95% 2.538-62.854; P= 0.002), and degree of severe-critical COVID-19 (OR, 108.771; Cl 95% 3.917-3020.095; P= 0.006). It can be concluded that ARDS, hyperkalemia, sepsis, ECOG >2 and degree of severe-critical COVID-19 have both statistical and clinical significance with mortality, but age >59 and anemia have no clinical significance."

"Latar Belakang: COVID-19 telah ditetapkan WHO sebagai Kedaruratan Kesehatan Masyarakat Yang Meresahkan Dunia dengan case fatality rate (CFR) di Indonesia mencapai 8,7% pada April 2020. Sampai saat ini belum ada biomarker prognosis untuk membedakan pasien yang membutuhkan perhatian segera dan menjadi prediktor mortalitas COVID-19 di ICU. Skor Simplified Acute Physiology Score 3 (SAPS 3) menilai kondisi pasien sejak pertama kali datang ke rumah sakit dan mengevaluasi data yang diperoleh saat masuk ICU dalam menentukan prediktor mortalitas 28 hari. Tujuan: Studi ini menganalisis hubungan skor SAPS 3 dengan mortalitas 28 hari pada pasien COVID-19 yang dirawat di ICU RSCM dan RSUI. Metode: Penelitian ini merupakan studi kohort retrospektif di Rumah Sakit Cipto Mangunkusumo selama bulan Maret-Agustus 2020. Sebanyak 208 subjek yang sesuai kriteria inklusi dianalisis dari data rekam medis. Data demografis dan penilaian skor SAPS 3 dicatat sesuai data rekam medis. Variabel SAPS 3 yang berpengaruh terhadap mortalitas 28 hari dilakukan analisis bivariat dan regresi logistik multivariat. Kesahihan dinilai menggunakan uji diskriminasi dengan melihat Area Under Curve (AUC) dan uji kalibrasi Hosmer Lemeshow. Titik potong optimal ditentukan secara statistik. Hasil: Angka mortalitas 28 hari akibat COVID-19 periode Maret-Agustus sebesar 43.8%. Variabel SAPS 3 yang secara statistik berpengaruh signifikan (p<0.05) terhadap mortalitas 28 hari pasien COVID-19 di ICU adalah usia, riwayat penggunaan obat vasoaktif sebelum masuk ICU, penyebab masuk ICU (defisit neurologis fokal dan gagal napas), kadar kreatinin dan trombosit. Skor SAPS 3 menunjukkan nilai diskriminasi yang baik (AUC 80.5% Interval Kepercayaan 95% 0.747-0.862) dan kalibrasi yang baik (Hosmer-Lemeshow p=0.395). Titik potong optimal skor SAPS 3 adalah 39 dengan sensitivitas 70.3% dan spesifisitas 74.4%. Kesimpulan: Skor SAPS 3 memiliki hubungan dengan mortalitas 28 hari pada pasien COVID-19 yang dirawat di ICU.

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Background: COVID-19 has been declared as a Public Health Emergency of International Concern by WHO with case fatality rate (CFR) of 8,7% in April 2020 in Indonesia. Until now, there is no prognostic biomarker to differentiate patients who require immediate attention and be a mortality predictor for COVID-19 patients in ICU. Simplified Acute Physiology Score 3 (SAPS 3) score assessed the patient’s condition since the first time he came to the hospital and evaluated the data obtained in the first hour of admission to the ICU in predicting 28-days mortality. Goals: This study aims to analyze the correlation between SAPS 3 score and 28-days mortality caused by COVID-19 in the ICU RSCM and RSUI.

Methods: This retrospective cohort study was conducted in Cipto Mangunkusumo Hospital from March to August 2020 on 208 subjects who met the inclusion criteria. Demographic data and SAPS 3 score were recorded, the data was taken from medical records. Bivariate and multivariate logistic regression was used to investigate the relationship between SAPS 3 variables and 28-days mortality. The validity of SAPS 3 score was assessed by measurement of the Area Under Curve (AUC) and Hosmer- Lemeshow calibration test. The optimal cut-off point was determined statistically.

Results: The mortality rate of COVID-19 in our study from March to August 2020 is 43.8%. Five SAPS 3 variables were found to be significantly associated with 28-days mortality of COVID-19 patients in the ICU (p<0.05) are age, use of vasoactive drugs before ICU admission, reason for ICU admission (focal neurologic defisit and respiratory failure), creatinine, and thrombocyte level. SAPS 3 showed a good discrimination ability (AUC 80.5% Confidence Interval 95% 0.747-0.862) and calibration ability (Hosmer-Lemeshow p=0.395). The optimal cut off point of SAPS 3 score was 39 with sensitivity 70.3% and specificity 74.4%.

Conclusion: SAPS 3 score have a correlation with 28-days mortality caused by COVID-19 in the ICU."