Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRACTPurposesVascular surgery (VS) has a higher perioperative mortality than other types of surgery. We compared different scores for predicting mortality in patients admitted to the intensive care unit (ICU) after open VS.MethodsPatients admitted to the ICU after open VS from 2006 to 2013 were included. We calculated the Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Preoperative Score to Predict Postoperative Mortality (POSPOM). We performed multivariate logistic regression to assess independent factors with the calculation of odds ratios (ORs) and 95% confidence intervals (CIs). We tested the predictive ability of the scores using the area under the receiver operating characteristics curve (AUROC).ResultsA total of 833 consecutive patients were included. Hospital mortality was 5,1% (1,3% after intermediate-risk and 8,4% after high-risk surgery). In the multivariate analysis, the age (OR 1,04, 95% CI 1,01-1,08, p = 0,013), smoking status (OR 2,46, 95% CI 1,16-5,21, p = 0,019), surgery risk (OR 2,92, 95% CI 1,058,08, p = 0,040), serum sodium level (OR 1,17, 95% CI 1,10-1,26, p < 0,001), urea (OR 1,01, 95% CI 1,01-1,02, p = 0,001) and leukocyte count (OR 1,05, 95% CI 1,01-1,10, p = 0,009) at admission were considered independent predictors. Hematocrit (0,86, 95% CI 0,80-0,93, p < 0.001) was considered an independent protective factor. The AUROC of our model was 0,860, compared to SAPS (0,752), APACHE (0,774), POSPOM (0,798) and POSSUM (0,829).ConclusionThe observed mortality was within the predicted range (1-5% after intermediate-risk and > 5% after high-risk surgery). POSSUM and POSPOM had slightly better predictive capacity than SAPS or APACHE."

"

Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) merupakan sistem skoring yang memprediksi morbiditas dan mortalitas berdasarkan 12 parameter fisiologis dan 6 parameter pembedahan. American Society of Anesthesiologist’s Physical Status (ASA-PS), yang terdiri dari 6 tingkatan, adalah skoring prediksi risiko pembedahan yang pertama kali dikembangkan dan paling sering digunakan saat ini. Penelitian ini bertujuan untuk menilai apakah kemampuan prediksi in-hospital mortality skoring P-POSSUM lebih baik dibanding skoring ASA-PS. Penelitian kohort retrospektif di RSCM selama bulan Mei-Juli 2018. Sebanyak 230 rekam medis diambil sesuai pasien yang menjalani laparotomi emergensi pada periode 1 Januari 2016-31 Desember 2017. Penilaian status ASA dicatat sesuai rekam medis dan dilakukan penilaian P-POSSUM. Analisis data dilakukan dengan komparatif Area Under the Curve (AUC), Hosmer Lemeshow goodness of fit dan multivariat regresi logistik. Angka in-hospital mortality pasien pascalaparotomi emergensi periode Januari 2016-Desember 2017 adalah sebesar 21,3%. Nilai kalibrasi ASA-PS lebih baik dibanding dengan P-POSSUM (p 0,072 vs 0,043). Nilai diskriminasi P-POSSUM lebih baik dibanding dengan ASA-PS (AUC 87,9% vs 76,2%). Komponen P-POSSUM yang paling berhubungan dengan in-hospital mortality adalah usia, riwayat gangguan napas, GCS, hemoglobin, natrium, kontaminasi intraperitoneal dan EKG. Skor P-POSSUM lebih baik dibanding ASA-PS dalam memprediksi in-hospital mortality pasien pascalaparotomi emergensi.

---

Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) is a scoring system which predicts morbidity and mortality based on 12 physiologic and 6 operative parameters. American Society of Anesthesiologist’s Physical Status (ASA-PS), consists of 6 categories, is the first scoring system predicting risk preoperatively and mostly use to this date. Our goals are to evaluate and compare the ability of these two scores in predicting mortality. This is a retrospective cohort taken place in RSCM within May to July 2018. There was 230 medical records taken as samples based on patient who underwent emergency laparotomy within period 1 January 2016 to 31 December 2017. ASA physical status was recorded and P-POSSUM score was assessed. Data were analyzed to compare Area Under the Curve (AUC), Hosmer Lemeshow goodness of fit and multivariate of logistic regression. In-hospital mortality of patient undergoing emergency laparotomy within period January 2016 to December 2017 is 21.3%.  Calibration performance of ASA-PS is better than P-POSSUM (p 0,072 vs 0,043). Discrimination performance of P-POSSUM is better than ASA-PS (AUC 87,9% vs 76,2%). Parameters of P-POSSUM, which most related with in-hospital mortality, are age, respiratory disorder, GCS, hemoglobin, sodium, intraperitoneal contamination and ECG. P-POSSUM is better than ASA-PS in predicting in-hospital mortality of patient undergoing emergency laparotomy.

"

"Latar belakang: Sindrom koroner akut SKA merupakan penyebab utama peningkatan morbiditas dan mortalitas di seluruh dunia. Mortalitas SKA dari berbagai studi di luar negeri diketahui berhubungan dengan kadar kalium serum saat admisi. Penelitian mengenai hubungan kadar kalium serum dengan mortalitas pada SKA masih perlu dilakukan karena adanya kemajuan dalam terapi kardiovaskular yang cukup pesat terutama pada era PCI saat ini dan adanya hasil yang bertolakbelakang antara studi terbaru dengan panduan yang ada. Tujuan: Menilai hubungan antara kadar kalium serum saat admisi dengan mortalitas selama perawatan pasien SKA in-hospital mortality. Metode: Data kadar kalium dan kematian diperoleh dari rekam medis dengan desain studi kohort retrospektif terhadap 673 pasien SKA yang dirawat dengan sindrom koroner akut di RSUPN Cipto Mangunkusumo. Keluaran utama yang diamati berupa mortalitas selama perawatan. Analisis bivariat dengan Pearson Chi-square dan multivariat menggunakan regresi logistik dilakukan untuk menentukan hubungan antara kadar kalium serum abnormal dengan kematian pada sindrom koroner akut. Hasil dan Pembahasan: Subjek yang datang dengan kadar kalium serum yang abnormal K < 3,50 mEq/L atau > 5,0 mEq/L saat admisi sebesar 24,22 163 pasien , sedangkan grup dengan kalium normal sebesar 510 subjek 75,78. Dari analisis regresi logistik, setelah adjustment terhadap faktor perancu eGFR, didapatkan hubungan yang bermakna antara kadar kalium serum abnormal saat admisi dengan mortalitas selama perawatan dengan nilai p = 0,04 adjusted RR 2,184; 95 CI: 1,037-4,601. Terjadi peningkatan risiko mortalitas pada subjek dengan kadar serum kalium 4,0-

---

Background: Acute coronary syndrome ACS is the leading cause of increased morbidity and mortality across the globe. This mortality was known to be associated to the serum potassium level on admission. More studies are still needed due to rapid advancement in cardiovascular medicine especially in the era of interventional cardiology and also the conflicting results that exist between recent studies and established guidelines.

Aims: To determine association between serum potassium levels on admission of subjects with acute coronary syndrome and in-hospital mortality.

Methods: Included in the study were 673 acute coronary syndrome patients hospitalised in Indonesian National Cipto Mangunkusumo Hospital. The outcome of the study was all-cause in-hospital mortality. Logistic regression models adjusted for risk factors, hospital treatment, and co-morbidities were constructed.

Results: Total of 163 patients 24,22 with abnormal serum potassium K < 3,50 mEq/L or > 5,0 mEq/L and 510 subjects with normal serum potassium 75.78. Logistic regression analysis after adjustment of the confounder eGFR shows significant association between serum potassium level on admission and in-hospital mortality with p value of 0,04 adjusted RR 2.184; 95 CI: 1.037-4.601. The risk of dying for patients with serum potassium of 4.0-."

"Latar belakang. Gagal jantung akut dan aritmia telah menjadi salah satu masalah kesehatan di bidang kardiovaskuler. Hubungan antara aritmia dan gagal jantung dalam mortalitas masih kontroversial. Tujuan. Mengetahui karakteristik pasien gagal jantung akut dan mengidentifikasi hubungan antara aritmia dengan mortalitas pasien gagal jantung akut di rumah sakit. Metode. Penelitian dilakukan dengan desain potong lintang dengan menggunakan metode consecutive sampling. Studi ini menggunakan 976 data sekunder dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 – 2006. Hasil. Dalam studi ini, pasien dikategorikan menjadi 2 kelompok, kelompok pasien gagal jantung akut dengan aritmia(42,2%) dan tanpa aritmia (67,8%). Pasien laki-laki mendominasi dengan 68%. Angka mortalitas pasien gagal jantung akut dengan aritmia selama perawatan adalah 4,1 %. Sedangkan pada pasien tanpa penyakit jantung koroner adalah 3,7%. Analisis bivariat menunjukkan tidak ada hubungan antara aritmia dengan mortalitas pasien gagal jantung akut (p=0,748 CI 95% 0,468-1,726, OR= 0,899). Kesimpulan. Tidak ada terdapat hubungan antara aritmia dengan angka mortalitas pasien gagal jantung akut selama perawatan.

---

Backgrounds. Acute heart failure (AHF) and arrhythmia have become problems in global heath related to cardiovascular. The association between arrhythmia and heart failure with mortality remains controversial. Objective. Define the characteristics of patients with acute heart failure and identify associations between arrhythmia and in-hospital mortality of acute heart failure patients. Methods. The design of this study was cross sectional with consecutive sampling. This study used 976 acute heart failure patients from Acute Decompensated Heart Failure Registry (ADHERE) of 5 hospital in Indonesia from december 2005-2006. Result. Patients in this study were categorized in two groups. The first group was patients with arrhythmia (42,2%) and the second was group wihout arrhythmia (67,8%). Majority of the patients were men with 68%. The mortality rate of the first group was 4,1% and from the second was 3,7%. The bivariat analysis showed that there is no association between arrhytmia and in-hospital mortality of AHF patients (p=0,748 CI 95% 0,468-1,726, OR= 0,899). Conclusions. Arrhythmia is not related to in-hospital mortality of AHF patients."

"Latar belakang. Gagal jantung akut telah menjadi masalah kesehatan diseluruh dunia sekaligus penyebab signifikan jumlah perawatan di rumah sakit serta menghabiskan biaya yang tinggi dalam penanganannya. Riwayat hipertensi merupakan salah satu faktor risiko utama pada terjadinya gagal jantung akut yang terjadi pada lebih dari 50% masyarakat berusia lebih dari 65 tahun. Hipertensi juga turut menjadi faktor yang mempengaruhi prognosis gagal jantung akut sehingga perlu penelitian lebih lanjut mengenainya. Tujuan. Penelitian ini dilakukan sebagai salah satu upaya untuk mengetahui lebih lanjut mengenai angka kejadian gagal jantung akut, proporsi pasien yang memilki riwayat hipertensi pada pasien gagal jantung akut, serta meneliti apakah terdapat hubungan antara riwayat hipertensi dengan angka mortalitas selama perawatan. Metode. Penelitian dilakukan dengan desain potong lintang serta menggunakan 685 data sekunder dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 – 2006. Hasil. Proporsi gagal jantung akut dengan hipertensi sebesar 58,4% dengan 68,3% terdiri dari pasien pria. Angka mortalitas pasien rawat gagal jantung akut dengan riwayat hipertensi adalah 3,3%. Sedangkan pada pasien tanpa riwayat hipertensi adalah 4,2%. Uji analisis bivariat menunjukkan bahwa tidak terdapat hubungan antara riwayat hipertensi dengan angka mortalitas pasien rawat gagal jantung (p=0,509). Kesimpulan. Tidak ada terdapat hubungan bermakna antara riwayat hipertensi dengan angka mortalitas selama perawatan.

---

Background. Acute heart failure is the main health problem all over the world and being a significant cause of hospitality. The treatment of heart failure is high in cost. Individual hypertension record is one of the risk factor of incidence of acute heart failure happened in more than 50% of the world population aged more than 65 years old. Hypertension itself can correlated with the prognosis of acute heart failure, therefore a new research about this is needed. Objective. This research is aimed for a deeper exploration about the incidence of acute heart failure, the number of acute heart failure patient with hypertension record, and to prove the correlation between hypertension record to the in-hospital mortality rate. Methods. The design of this study was cross sectional with consecutive sampling. This study used 976 acute heart failure patients from Acute Decompensated Heart Failure Registry (ADHERE) of 5 hospital in Indonesia from december 2005- 2006. Result. Patients in this study were categorized in two groups. The first group was patients with hypertension history (58,4%) and the second was group wihout hypertension history (41,6%). Majority of the patients were men with 68,3%. The mortality rate of the first group was 3,3% and from the second was 4,2%. The bivariat analysis showed that there is no association between hypertension history and in-hospital mortality of AHF patients (p=0,509). Conclusion. Hypertension history is not related to in-hospital mortality of AHF patients."

"Latar belakang. Gagal jantung akut telah menjadi masalah kesehatan diseluruh dunia. Merokok merupakan salah satu faktor utama dalam insidensi penyakit kardiovaskular dan gagal jantung dan mempengaruhi baik morbiditas maupun mortalitas pada kasus gagal jantung. Saat ini terdapat perbedaan pendapat mengenai pengaruh merokok dengan angka mortalitas akibat gagal jantung.Tujuan. Mengetahui karakteristik pasien gagal jantung akut dan mengidentifikasi hubungan antara riwayat merokok dengan mortalitas pasien gagal jantung akut selama perawatan.Metode. Penelitian dilakukan dengan desain potong lintang dan menggunakan 826 data sekunder dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 ? 2006.Hasil. Proporsi pasien gagal jantung akut yang mempunyai riwayat merokok di lima rumah sakit di Indonesia pada bulan Desember 2005 ? 2006 mencapai 50,2 %. Angka mortalitas pasien gagal jantung akut adalah 3,6 %. Angka mortalitas pasien gagal jantung akut baik dengan maupun tanpa adalah 3,6 %. Analisis bivariat menunjukkan p=0,978 OR 1,010 CI 0,487-2,094Kesimpulan. Tidak terdapat hubungan bermakna antara riwayat penyakit jantung koroner dengan angka mortalitas gagal jantung akut di lima rumah sakit di Indonesia pada bulan Desember 2005 ? 2006.Background. Acute heart failure has become health problem on the world. Cigarette smoking is a well-established risk factor for cardiovascular disease and heart failure. Nowadays there are controversies between smoking and heart failure mortality Objectives.

Aim. To determine characteristic of patient and relation between history of smoking and mortality of acute heart failure.

Method. This is cross sectional study using 826 data from Acute Decompensated Heart Failure Registry (ADHERE) in five hospital in Indonesia on December 2005 -2006.

Result. 50.2 % patients have history of smoking. Overall in-hospital mortality among patient with acute heart failure is 3.6 %. In-hospital mortality in patient with or without history of smoking is 3.6% with p = 0.978.

Conclusion. There is no significant relation between history of smoking and mortality of acute heart failure in five hospitals in Indonesia on December 2005 -2006."

"Latar belakang. Dislipidemia merupakan salah satu faktor resiko berkembangnya gagal jantung dan telah menjadi masalah kesehatan diseluruh dunia. Penelitian mengenai hubungan dislipidemia dan penyakit jantung belum banyak dilakukan di Indonesia.Tujuan. Mengetahui karakteristik pasien gagal jantung akut dan mengidentifikasi hubungan antara riwayat dislipidemia dengan mortalitas pasien gagal jantung akut selama perawatan.Metode. Penelitian dilakukan dengan desain potong lintang serta menggunakan 268 data sekunder dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 - 2006.Hasil. Pasien gagal jantung akut dalam penelitian ini dibagi kedalam dua kelompok. Kelompok pertama merupakan pasien dengan dislipidemia (88,8% dan kelompok kedua meupakan pasien tanpa dislipidemia (12,2%). Angka mortalitas pada kelompok pertama mencapai 3,0% dan pada kelompok kedua 0%. Melalui analisis bivariat tidak didapatkan hubungan bermakna antada riwayat dislipidemia dengan mortaitas pasien gagal jantung akut (p=0,603; OR: 0,828; CI: 0,101-6,759).Kesimpulan. Tidak terdapat hubungan bermakna antara riwayat dislipidemia dengan angka mortalitas gagal jantung akut selama perawatan di lima rumah sakit di Indonesia pada bulan Desember 2005 - 2006.

---

Background. Dyslipidemia can promote the development of heart failure and has become one of global health problem. The study about associatin between dyslipidemia and in-hospital mortality of acute heart failure has never been done before in Indonesia.Objective. To define the characteristic of patient and to identify the association between dyslipidemia and in-hospital mortality of acute heart failure.Method. The design of this study was cross sectional with onsecutive sampling. This study used 976 acute heart failure patients from Acute Decompensated Heart Failure Registry (ADHERE) of 5 hospital in Indonesia from December 2005-2006.Result. Patiens with acute heart failure in this study were categorized in two groups. The first group was patients with dyslipidemia (88,8%) and the second was group wihout dyslipidemia (12,2%). The mortality rate of the first group was 3,0% and from the second was 0%. The bivariat analysis showed that there is no association between dyslipidemia and in-mortality of AHF patients (p=0,603; OR: 0,828; CI: 0,101-6,759).Conclusion. There is no significant association between Dyslipidemia and Inhospital Mortality of Acute Heart Failure in Five Hospital in Indonesia on December 2005 -2006."

"Latar belakang. Gagal jantung akut merupakan salah satu masalah kesehatan utama di seluruh dunia. Gagal jantung akut sering disertai dengan gagal ginjal kronik sebagai penyakit penyerta.Tujuan. Mengetahui hubungan antara riwayat gagal ginjal kronik dengan mortalitas pada pasien gagal jantung akut, yang dapat digunakan sebagai masukan untuk lebih mengoptimalkan penatalaksanaan pasien gagal jantung akut dengan riwayat gagal ginjal kronik di rumah sakit di Indonesia.Metode. Penelitian dilakukan dengan desain potong lintang dengan sampel berupa data sekunder pasien dengan diagnosis gagal jantung akut dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 - Desember 2006.Hasil. Sampel seluruhnya berjumlah 882, terdiri dari 68,5% laki-laki dan 31,5% perempuan dengan rerata usia 59 tahun. Sampel dengan riwayat gagal ginjal kronik sebanyak 154 orang (68,2% laki-laki, 31,8% perempuan, rerata usia 56 tahun). Angka mortalitas di rumah sakit seluruh sampel 4,2%. Angka mortalitas sampel dengan riwayat gagal ginjal kronik 7,1%, hampir dua kali lipat angka mortalitas sampel tanpa riwayat gagal ginjal kronik, yang sebesar 3,6%. Didapatkan p = 0,045, OR = 2,07, dan CI 95% = 1,003 - 4,299.Kesimpulan. Terdapat hubungan bermakna antara riwayat gagal ginjal kronik dengan mortalitas di rumah sakit pada pasien gagal jantung akut. Risiko timbulnya mortalitas pada sampel dengan riwayat gagal ginjal kronik adalah dua kali lipat risiko tersebut pada sampel tanpa riwayat gagal ginjal kronik.

---

Background. Acute heart failure is one of the major health problem around the world. Acute heart failure and chronic renal failure are often coexist.

Objective. In order to answer the question whether there is a significant correlation between previously diagnosed chronic renal failure and in-hospital mortality on patients with acute heart failure, so the result can be used as a suggestion to improve the quality of therapy on hospitalized acute heart failure patients.

Method. This study use cross sectional method with sample taken from secondary data of patient diagnosed for acute heart failure on Study Acute Decompensated Heart Failure Registry (ADHERE) in five hospitals in Indonesia on December 2005 - December 2006.

Result. Total sample is account for 882 patients, consist of 68,5% men and 31,5% women, with mean of age 59 years old. Sample with previously diagnosed chronic renal failure consist of 154 patients (68,2% men, 31,8% women, mean of age 56 years old). In-hospital mortality rate is 4,2% on total sample. In-hospital mortality rate on sample with previously diagnosed chronic renal failure is 7,1%, almost two times higher than in-hospital mortality rate on sample without previously diagnosed chronic renal failure, which is only 3,6% (p = 0,045, OR = 2,07, dan CI 95% = 1,003 - 4,299).

Conclusion. There is significant correlation between previously diagnosed chronic renal failure and in-hospital mortality on patients with acute heart failure. The risk for sample with previously diagnosed chronic renal failure to developed mortality during hospitalization is two times higher than sample without previously diagnosed chronic renal failure."