Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Di negara maju, angka mortalitas gastroskisis adalah 5-10%, berbeda dengan di negara berkembang. Angka mortalitas gastroskisis mencapai 52% di Brazil, 43% di Afrika Selatan, 35% di Iran, dan 79% di Jamaika. Di RSUPN Cipto Mangunkusumo (RSCM), sampai saat ini belum ada data mengenai angka mortalitas gastrosksis. Angka mortalitas gastroskisis di RSCM perlu diketahui karena karakteristik pasien yang diperkirakan berbeda dengan di negara maju. Tujuan dari penelitian ini adalah untuk mengetahui angka mortalitas gastroskisis di RSCM serta mengidentifikasi faktor risiko yang berpengaruh terhadap mortalitas gastroskisis, antara lain: usia kehamilan, berat badan lahir, jumlah operasi, usia saat operasi pertama kali, serta gastroskisis komplikata.Metode: Metode penelitian ini adalah studi kohort retrospektif dengan total sampling seluruh neonatus yang menjalani operasi penutupan defek di RSCM dari Januari 2015 – September 2020. Analisis bivariat dilakukan menggunakan uji Chi Square atau uji Fisher. Didapatkan 49 subjek neonatus dengan 7 data masuk kategori drop out sehingga 42 subjek diambil untuk dianalisis.Hasil: Angka mortalitas neonatus dengan gastroskisis di RSCM tahun 2015-2020 adalah 69% (29 dari 42 subjek). Pada penelitian ini didapatkan usia saat operasi (<1 hari) berpengaruh menurunkan angka mortalitas gastrosksis (p = 0,005). Usia kehamilan, berat badan lahir, jumlah operasi, dan gastroskisis komplikata didapatkan tidak berpengaruh terhadap angka mortalitas gastroskisis.Kesimpulan: Angka mortalitas gastrokisis di RSCM adalah 69% dan dipengaruhi oleh usia saat operasi.

---

Background: Unlike developing countries, the mortality rate of gastroschizis in developed countries is much lower, accounting at 5-10%. In developing countries, for example, Brazil, the mortality rate can reach up to 52%, 43% in South Africa, 35% in Iran, and 79% in Jamaica. Until recently, there are no data regarding gastrochizis-related mortality rate in Cipto Mangkunkusumo National Referral Hospital, Indonesia. This is important as it reflects patient characteristics that is different with developed countries. The objective of this research is to find out the mortality rate of gastroschizis in Indonesia along with other possible influencing risk factors such as; gestational age, birth weight, number of operations, age at closure, and the presence of complicated gastroschizis.

Methods: A cohort retrospective study with total sampling is used to document all neonates who undergo defect closure surgery from January 2015 to September 2020. Bivariate analysis is done using Chi Square test or Fisher test. A total of 49 neonates were documented, however 7 neonates were excluded due to drop out criteria, resulting in 42 neonates who were included in the analysis.

Results: The mortality rate of gastroschizis in Cipto Mangkunkusumo National Referral Hospital is 69% (29 out of 42 subjects). The age at closure is related to lower mortality rate (p = 0.005), while other factors such as gestational age, birth weight, number of operations, and the presence of complicated gastroschizis has no impact on mortality.

Conclusions: The mortality rate of gastroschizis in Cipto Mangkunkusumo National Referral Hospital is 69% and is influenced by age at closure."

"Latar belakang: Usia operasi Fontan terbaik masih kontroversial. Pusat jantung di negara maju menggunakan batasan usia 2-4 tahun. Kebanyakan operasi Fontan di Indonesia dikerjakan pada usia tua. Dengan kemajuan teknik operasi, bagaimana dampak usia tua saat operasi Fontan terhadap kesintasan belum ada datanya. Tujuan: Mengetahui pengaruh usia tua saat operasi Fontan terhadap kesintasan jangka panjang. Metode: Penelitian ini merupakan studi kohort retrospektif dengan analisis kesintasan terhadap pasien pascaoperasi Fontan (1 Januari 2008-31 Desember 2019) di Pusat Jantung Nasional Harapan Kita. Pengumpulan data dilakukan dari rekam medis, konferensi bedah, serta follow-up melalui telepon atau surat hingga 1 April 2020. Usia dibagi menjadi usia ≤ 6 tahun dan > 6 tahun. Hasil: Dari total 261 subjek, median usia operasi yaitu 5 tahun (2-24 tahun). Kesintasan usia operasi ≤ 6 tahun dan > 6 tahun yaitu 95,7% dan 89,3%. Hasil subanalisis kesintasan usia operasi < 4 tahun, 4-6 tahun (referensi), 6-8 tahun, 8-10 tahun, 10-18 tahun, dan > 18 tahun yaitu 90,5%, 97,9%, 93,8%, 84,8%, 91,4%, dan 66,7%. Usia 8-10 tahun (HR 6,79; p = 0,022), 10-18 tahun (HR 3,76; p = 0,147), dan >18 tahun (HR 15,30; p = 0,006) memiliki kesintasan terendah. Usia operasi > 6 tahun (HR 3,84; p = 0,020) dan kebutuhan furosemid jangka panjang (HR 3,90; p = 0,036) signifikan meningkatkan risiko kematian pada analisis multivariat. Kesimpulan: Usia operasi Fontan > 6 tahun signifikan menurunkan kesintasan jangka panjang. Usia operasi 8-10 tahun dan > 18 tahun memiliki risiko kematian 6,7 kali dan 15,3 kali dibandingkan usia 4-6 tahun.

---

Background: The optimal age to perform the Fontan procedure is still unknown. Currently, the majority of centres worldwide are performing the procedure between 2 and 4 years old. Most of Fontan procedures in Indonesia are performed at older age. With the advancement in surgical techniques, there is no data regarding the impact of older age at completion of Fontan procedure on long term survival.

Objective: To evaluate the impact of older age at Fontan procedure on long term survival.

Methods: We conducted a retrospective cohort study with survival analysis, of patients underwent Fontan completion (Januari 1, 2008, to December 31, 2019), at National Cardiovascular Center Harapan Kita. The data was collected from medical records, surgical conference, and follow up by phone or mail to the end of the study (April 1, 2020). The age of operation was categorized into ≤ 6 years old and > 6 years old.

Results: Of 261 subjects, the median age was 5 years (2-24 years). The survival rate of operation age ≤ 6 years old and > 6 years old were 95.7% and 89.3%. The survival rate in subgroup analysis of operation age < 4 years, 4-6 years (reference age), 6-8 years, 8-10 years, 10-18 years, and > 18 years were 90.5%, 97.9%, 93.8%, 84.8%, 91.4%, and 66.7% respectively. The age of operation 8-10 years (HR 6.79; p = 0.022), 10-18 years (HR 3.76; p = 0.147), and > 18 years (HR 15.30; p = 0.006) had worse survival rate than the others. In multivariate analysis, age of Fontan completion > 6 years old (HR 3.84; p = 0.020) and need for furosemide use (HR 3.90; p = 0.036) significantly increased long term mortality.

Conclusion: The age of operation > 6 years old was significantly reduced long term survival rate. The age of 8-10 years old and > 18 years old had higher risk of death (6.7 times and 15.3 times) than age of 4-6 years old."