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"ABSTRAK Tujuan: mendapatkan kuesioner Minnesota Living with Heart Failure MLHFQ versi bahasa Indonesia yang sahih dan handal untuk digunakan di Indonesia. Metode: studi ini merupakan studi potong lintang dengan 85 subyek rerata usia 58 11, pria 55 pasien gagal jantung kronik di poli kardiologi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta. Kesahihan diuji dengan menilai kesahihan konstuksi multitrait multimethod analysis dan kesahian eksternal dengan membandingkan dengan kuesioner SF-36. Keandalan dinilai dengan menggunakan cronbach ?, dan intraclass coefficient correlation ICC . Hasil: MLHFQ bahasa Indonesia memiliki korelasi sedang-kuat antara domain dan item pertanyaan r 0,571-0,748, ABSTRACT Aim to obtain a valid and reliable Indonesian version of MLHFQ for Indonesian application. Methods This cross sectional study enroled 85 patients mean age 58 11, male 55 with chronic heart failure of of cardiology clinic Ciptomangunkusumo Central Hospital Jakarta. Validity of MLHFQ was evaluated by measuring construct validity using multitrait multimethod analysis and by compairing MLHFQ with SF 36. Reliability of MLHFQ was evaluated by calculating Intraclass Correlation Coefficient ICC and by calculating cronbach to determine internal consistency Results Indonesian version of MLHFQ has moderated strong correlation item to domain correlation r 0,571 0,748, p"

"Objektif: Penelitian ini bertujuan untuk mengetahui karakteristik subjek penelitian dan pengaruh latihan aerobik selama delapan minggu terhadap perbaikan kualitas hidup menggunakan kuesioner Minnesota Living with Heart Failure (MLHF). Metode: Penelitian ini adalah studi pre dan post latihan aerobik pada pasien gagal jantung kronik stabil. Subjek penelitian melakukan latihan berjalan tiga kali seminggu dengan intensitas sesuai Rating of Perceived Exertion 12-13, durasi latihan dimulai selama 10 menit dengan penambahan jarak 100-200 meter per sesi latihan berdasarkan toleransi subjek selama delapan minggu dan penilaian kualitas hidup menggunakan kuesioner Minnesota Living with Heart Failure dan uji jalan enam menit sebelum dan sesudah latihan aerobik selama delapan minggu. Hasil: Jumlah subjek penelitian sebesar 20 subjek (15 laki-laki dan 5 perempuan). Subjek penelitian didominasi oleh lanjut usia (10 orang), sudah menikah (16 orang), riwayat pendidikan DIII/S1 (10 orang), status bekerja (11 orang), obesitas tingkat I (7 orang), kelas fungsional NYHA II (19 orang), kondisi penyerta berupa hipertensi (16 orang) dan gaya hidup sedenter (18 orang). Perbandingan skor kuesioner MLHF sebelum dan sesudah latihan aerobik mengalami perbaikan bermakna secara statistik (p < 0.001), dimana skor domain fisik dan domain emosional mengalami perbaikan yang bermakna secara statistik (p < 0,001). Perbandingan delta domain fisik dengan delta domain emosional didapatkan bermakna secara statistik (p < 0,001). Perbandingan uji jalan enam menit sebelum dan sesudah latihan aerobik bermakna secara statistik (p< 0,001). Didapatkan hubungan bermakna secara statistik antara usia (p= 0,009) dan status pernikahan (p= 0,037) terhadap skor MLHF. Kesimpulan: Terdapat perbaikan kualitas hidup pada gagal jantung kronik stabil setelah latihan aerobik fase II selama delapan minggu. Terdapat hubungan pada usia dan status pernikahan terhadap skor MLHF.

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Objective: This study aims to determine the characteristics of study subjects and the impact of aerobic exercise over eight weeks on the improvement of quality of life using the Minnesota Living with Heart Failure (MLHF) questionnaire. Method: This is a pre and post-aerobic exercise study on stable chronic heart failure patients. Study subjects engaged in walking exercises three times a week with an intensity based on the Rating of Perceived Exertion of 12-13. Exercise duration started at 10 minutes with an addition of 100-200 meters per exercise session based on the subject's tolerance over eight weeks. Assessment of quality of life was conducted using the Minnesota Living with Heart Failure questionnaire and six-minute walking test before and after aerobic exercise for eight weeks. Result: The total number of study subjects was 20 (15 males and 5 females). Study subjects were predominantly elderly (10 individuals), married (16 individuals), with a Diploma/Bachelor education background (10 individuals), employed (11 individuals), categorized as class I obesity (7 individuals), NYHA functional class II (19 individuals), having hypertension comorbidity (16 individuals), and leading a sedentary lifestyle (18 individuals). Comparison of MLHF questionnaire scores before and after aerobic exercise showed a statistically significant improvement (p < 0.001), with significant improvements in both physical and emotional domains (p < 0.001). Comparison of the delta in the physical domain and the emotional domain was also statistically significant (p < 0.001). Comparison of the six-minute walking test before and after aerobic exercise was statistically significant (p < 0.001). There was a statistically significant association between age (p= 0.009) and marital status (p= 0.037) with MLHF scores. Conclusion: There was an improvement of quality of life in stable chronic heart failure patients after aerobic exercise in phase II for eight weeks. There was a significant association between age and marital status with MLHF scores."

"ABSTRAK Abstrak :Obstructive Sleep Apnea (OSA) erat dikaitkan dengan penyakitmetabolik seperti hipertensi dan dislipidemia. Pasien dengan OSA juga seringditemukan pada pasien gagal jantung.Obsturctive sleep Apnea dapatmemeperberat gagal jantung.Objektif :Penelitian ini bertujuan mengetahuiprevalens dan faktor-faktor yangmemengaruhi kejadian OSA pada pasien gagal jantung kronik di RSUPPersahabatan Jakarta.Metode :Disain penelitian ini adalah potong lintang observasi. Pasien CHF FC I -II berkunjung ke poliklinik jantung dan vaskular RSUP Persahabatan yangmemenuhi kriteria inklusi dan eksklusi. Subjek dilakukan anamnesis,pemeriksaan fisis dan eko kardiografi untuk memastikan diagnosis CHFdandilanjutkan dengan wawancara menggunakan kuesioner Berlin untuk menentukanrisiko tinggi OSA kemudian dilanjutkan pemeriksaan polisomnografi laludilakukan analisis statistik.Hasil :Penelitian potong lintang ini dilakukan pada 70 sampel pasien gagaljantung. Dengan menggunakan kuesioner Berlin diperoleh sebanyak 42 pasien(60%) yang ditemukan berisiko tinggi OSA. Dengan menggunakan uji chi squareditemukan bahwa faktor usia (p=0,988), jenis kelamin (p=0,678), IMT (p=0,170),lingkar leher (p=0,605), lingkar perut (p=0,189), tekanan darah (p=0,922),merokok (p=0,678) dan fraksi ejeksi ≦40% (p= 0.109) tidak ditemukan memilikihubungan bermakna dengan risiko OSA pada pasien gagal jantung. Sementarafaktor ukuran tonsil ditemukan memiliki hubungan bermakna (p=0,005). Dari 42orang tersebut dipilih secara acak 26 orang untuk dilakukan pemeriksaan lanjutanpolisomnografi dan didapatkan pasien gagal jantung menderita OSA ringandengan nilai AHI 5 ? 15 sebanyak 7 pasien (26.7%), OSA sedang dengan AHI15-30 sebanyak 9 pasien (34.5%) dan OSA berat dengan AHI>30 sebanyak 10pasien (38.8%).Kesimpulan :prevalens pasien CHF FC I - II yang memiliki risiko tinggi OSAberdasarkan kuesioner Berlin dengan nilai >2 adalah sebanyak 42 orang (60%)dengan faktor risiko ukuran tonsil yang bermakna menyebabkan terjadinya OSApada CHF ABSTRACT Background: Obstructive Sleep Apnea (OSA) commonly associated withmetabolic disease including hypertension and dyslipidemia. Patients with OSA isalso commonly found in conjunction with heart failure condition.Obstructivesleep apnea can cause CHF getting worstObjective:This study aims to acknowledge prevalence of OSA and influencefactors in heart failure patients in Persahabatan HospitalMethods:Thisobservational cross sectionalstudy was being done in 70 sampleschronic heart failure patients who visited in cardio and vascular disease clinic inPersahabatan Hospital with fuctional class I - II who met the inclusion andexclusion criteria. Subjects were asked for history of disease, physicalexamination and echocardiography then underwentBerlins Questionnaire thenfollowed by polysomnography examination to detect the presence of OSA.Results: Observational cross sectionalstudy done in 70 samples chi square testcan be concluded that age (p=0,988), gender (p=0,678), Body Mass Index(p=0,170), neck circumference(p=0,605), abdominal circumference (p=0,189),blood pressure (p=0,922),smoking (p=0,678) and ejection fraction ≦40%(p=0.109),many factors are not significantly related to the risk of OSA in heartfailure patients.Meanwhile, tonsillar size is found to have significantly related toincidence of OSA in heart failure patients (p=0,005). 46 patients who have highrisk of OSA by Berlins questionnaire selected by random to get 26 patients whowill follow polysomnography examination, result for patients CHF with mildOSA AHI 5 -15 are 7 patients (26.7%), moderate OSA with AHI 15 - 30 are 9patients (34.5%) and severe OSA with AHI ≥ 30 are 10 patients (38.8%).Conclusion:The prevalence of CHF FC I - II with high risk OSA that screenedby Berlins Questionnaire in CHF patiens are 43 patients (60%) with tonsillar sizeis found to have significantly related to incidence of OSA.;Background: Obstructive Sleep Apnea (OSA) commonly associated withmetabolic disease including hypertension and dyslipidemia. Patients with OSA isalso commonly found in conjunction with heart failure condition.Obstructivesleep apnea can cause CHF getting worstObjective:This study aims to acknowledge prevalence of OSA and influencefactors in heart failure patients in Persahabatan HospitalMethods:Thisobservational cross sectionalstudy was being done in 70 sampleschronic heart failure patients who visited in cardio and vascular disease clinic inPersahabatan Hospital with fuctional class I - II who met the inclusion andexclusion criteria. Subjects were asked for history of disease, physicalexamination and echocardiography then underwentBerlins Questionnaire thenfollowed by polysomnography examination to detect the presence of OSA.Results: Observational cross sectionalstudy done in 70 samples chi square testcan be concluded that age (p=0,988), gender (p=0,678), Body Mass Index(p=0,170), neck circumference(p=0,605), abdominal circumference (p=0,189),blood pressure (p=0,922),smoking (p=0,678) and ejection fraction ≦40%(p=0.109),many factors are not significantly related to the risk of OSA in heartfailure patients.Meanwhile, tonsillar size is found to have significantly related toincidence of OSA in heart failure patients (p=0,005). 46 patients who have highrisk of OSA by Berlins questionnaire selected by random to get 26 patients whowill follow polysomnography examination, result for patients CHF with mildOSA AHI 5 -15 are 7 patients (26.7%), moderate OSA with AHI 15 - 30 are 9patients (34.5%) and severe OSA with AHI ≥ 30 are 10 patients (38.8%).Conclusion:The prevalence of CHF FC I - II with high risk OSA that screenedby Berlins Questionnaire in CHF patiens are 43 patients (60%) with tonsillar sizeis found to have significantly related to incidence of OSA.;Background: Obstructive Sleep Apnea (OSA) commonly associated withmetabolic disease including hypertension and dyslipidemia. Patients with OSA isalso commonly found in conjunction with heart failure condition.Obstructivesleep apnea can cause CHF getting worstObjective:This study aims to acknowledge prevalence of OSA and influencefactors in heart failure patients in Persahabatan HospitalMethods:Thisobservational cross sectionalstudy was being done in 70 sampleschronic heart failure patients who visited in cardio and vascular disease clinic inPersahabatan Hospital with fuctional class I - II who met the inclusion andexclusion criteria. Subjects were asked for history of disease, physicalexamination and echocardiography then underwentBerlins Questionnaire thenfollowed by polysomnography examination to detect the presence of OSA.Results: Observational cross sectionalstudy done in 70 samples chi square testcan be concluded that age (p=0,988), gender (p=0,678), Body Mass Index(p=0,170), neck circumference(p=0,605), abdominal circumference (p=0,189),blood pressure (p=0,922),smoking (p=0,678) and ejection fraction ≦40%(p=0.109),many factors are not significantly related to the risk of OSA in heartfailure patients.Meanwhile, tonsillar size is found to have significantly related toincidence of OSA in heart failure patients (p=0,005). 46 patients who have highrisk of OSA by Berlins questionnaire selected by random to get 26 patients whowill follow polysomnography examination, result for patients CHF with mildOSA AHI 5 -15 are 7 patients (26.7%), moderate OSA with AHI 15 - 30 are 9patients (34.5%) and severe OSA with AHI ≥ 30 are 10 patients (38.8%).Conclusion:The prevalence of CHF FC I - II with high risk OSA that screenedby Berlins Questionnaire in CHF patiens are 43 patients (60%) with tonsillar sizeis found to have significantly related to incidence of OSA."

"Pendahuluan. Gagal jantung merupakan penyakit kronik dengan angka perawatan ulang satu tahun yang tinggi. Program Multidisiplin (multidisciplinary program, MDP) yang melibatkan tenaga medis dan nonmedis termasuk dokter kardiologi, dokter bedah jantung, dokter rehabilitasi medik, dokter gizi klinik, perawat dan fisioterapis mampu menurunkan angka perawatan ulang satu tahun sebesar 74%. Klinik Gagal Jantung Instalasi Pelayanan Jantung Terpadu (PJT) RSCM yang mengusung penerapan MDP telah berdiri sejak bulan Nopember 2018, tetapi belum ada data yang tersedia mengenai pengaruh MDP pada angka perawatan ulang pasien gagal jantung kronik. Penelitian ini bertujuan untuk mengetahui peranan MDP terhadap penurunan angka perawatan ulang satu tahun pasien gagal jantung kronik di RSCM. Metode. Penelitian menggunakan desain studi kohort retrospektif yang menggunakan data sekunder pasien gagal jantung kronik kelas NYHA II-IV yang menjalani rawat jalan di poliklinik PJT RSCM tahun 2017 dan 2019. Pasien diikuti hingga satu tahun pasca kontrol pertama untuk dinilai apakah mengalami perawatan ulang di rumah sakit. Dilakukan analisis bivariat untuk melihat pengaruh dari MDP terhadap angka perawatan ulang rumah sakit satu tahun dan analisis multivariat untuk menilai apakah pengaruh tersebut dipengaruhi oleh usia, jenis kelamin, kelas fungsional NYHA, komorbid, kepatuhan berobat, obesitas, anemia dan pembiayaan. Hasil. Dari 133 subjek penelitian, sebagian besar subjek adalah laki-laki dengan median usia adalah 57 tahun. Angka perawatan ulang satu tahun sebelum penerapan MDP adalah 47,54%, sedangkan sesudah MDP adalah 38,89%, dengan penurunan angka perawatan ulang satu tahun pada kelompok yang sudah menjalani MDP sebesar 8,65% dan NNT 12. Dibandingkan dengan kelompok yang belum MDP, terjadi penurunan risiko perawatan ulang satu tahun pada kelompok yang sudah menjalani MDP sebesar 18,2%. Tidak didapatkan pengaruh yang bermakna secara statitistik antara MDP dan angka perawatan ulang satu tahun dengan nilai RR 0,818 (IK95%: 0,553 – 1,210, p=0,315). Faktor usia, jenis kelamin, kelas NYHA, komorbid, obesitas, anemia, kepatuhan, dan pembiayaan tidak menjadi faktor perancu pengaruh program MDP terhadap angka perawatan ulang satu tahun pasien gagal jantung kronik di RSCM. Kesimpulan. Penerapan program multidisiplin (MDP) menyebabkan penurunan risiko perawatan ulang satu tahun pasien gagal jantung kronik di RSCM sebesar 18,2%, namun diperlukan penelitian lebih lanjut dengan sampel yang lebih besar untuk meningkatkan kekuatan statistik.

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Introduction. Heart failure is a chronic disease with high readmission rate. The multidisciplinary program (MDP), involving medical and non-medical personnel including cardiologists, cardiac surgeons, cardiac rehabilitation doctors, clinical nutritionists, nurses and physiotherapists is known to reduce the one-year readmission rate by 74%. The Heart Failure Clinic in PJT RSCM has implemented MDP since November 2018, but there is no data available regarding the effect of MDP on the readmission rate of chronic heart failure patients. This study aims to determine the effect of MDP on reduction of the one-year readmission rate of chronic heart failure patients in RSCM. Method. This retrospective cohort study is conducted using medical record from NYHA class II-IV chronic heart failure patients undergoing outpatient care in RSCM Polyclinic in year 2017 and 2019. Patients were followed up in one year after the first control to assess whether they experienced readmission or not. Bivariate analysis was performed to analyze the impact of MDP on the incidence of one-year hospital readmission and multivariate analysis to assess whether the impact was influenced by age, sex, NYHA functional class, comorbidities, medication adherence, obesity, anemia and funding. Results. Of the 133 research subjects, most were male with a median age 57 age years old. The readmission rate before MDP was 47.54%, while after MDP it was 38.89%, with absolute reduction on incidence of 8,65%. Compare to subjects before MDP, subjects whose had MDP has a reduction of one-year readmission risk of 18,2% and NNT of 12. There is no statistically significance of MDP regards to one-year readmission rate of chronic heart failure patients in RSCM with RR value of 0.818 (IK95: 0.553 – 1.210, p=0.315). Age, gender, NYHA class, comorbidities, obesity, anemia, adherence, and funding were not as confounding factors for the effect of the MDP program on one-year readmssion of chronic heart failure patients in RSCM. Conclusion. The multidisciplinary program (MDP) reduced risk of one-year readmission of chronic heart failure by 18.2%, however further studies with larger samples are needed to improve statistical power."

"Self-care merupakan bagian penting dalam upaya peningkatan kualitas hidup pasien gagal jantung. Self-care adalah pengambilan keputusan secara natural oleh individu dalam berperilaku untuk mempertahankan kestabilan fisiologis tubuhnya dan sebagai respon terhadap tanda dan gejala yang terjadi pada diri individu. Keadekuatan individu dalam melakukan self-care dapat dipengaruhi oleh berbagai faktor internal maupun eksternal dari individu. Identifikasi faktor tersebut menjadi bagian penting untuk memberikan asuhan keperawatan mengenai self-care yang efektif. Penelitian ini bertujuan untuk mengidentifikasi pengaruh dari karakteristik responden, status fungsional, komorbiditas, lama diagnosis, tingkat pengetahuan, tingkat depresi, serta dukungan sosial terhadap self-care. Desain penelitian menggunakan cross sectional survey pada 120 responden yang diambil dengan tehnik purposive sampling di Poliklinik Jantung. Penelitian menggunakan kuesioner SCHFI (self-care heart failure index) dalam mengukur self-care responden. Hasil penelitian menunjukan pekerjaan (p=0,055; CI 95%), pendidikan (p=0,232; CI 95%), dan penghasilan (p=0,027; CI 95%) mempengaruhi self-care individu secara signifikan. Responden yang bekerja, berpendidikan tinggi, dan berpenghasilan lebih dari Rp. 2.000.000 memiliki self-care yang lebih adekuat.

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Adherence to self-care is important for heart failure patients to improve their quality of life. Self-care defined as individual naturalistic decision making process that's patients use in the choice of behaviors that maintain physiological stability and as a respons to underlying sign and symptoms. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions.

The Aim of study was to analyze and identified factors (characteristic, functional class, comorbidity, time was diagnosed, knowledge, depression, and social support) influencing self-care. Cross sectional design used in this study to measure 120 outpatients using Self-Care Heart Failure Index (SCHFI) Indonesian version questioner.

The result of the study indicated employe/e patients (p=0,055; CI 95%), have education higher than junior high school (p=0,232; CI 95%), and have income higher than Rp. 2.000.000 (p=0,027; CI 95%) showed more adequate in self-care behaviour. Self-care strategies for HF should targeted for patient with lower education, unemployed, and have an income lower than Rp. 2.000.000 to improve their quality of life."

"Latar Belakang: Gagal jantung merupakan salah satu penyebab kematian utama di Indonesia. Jantung dan ginjal berhubungan dengan erat yang dapat dijelaskan oleh sindrom kardiorenal. Saat ini, ada kekurangan data di rumah sakit tersier di Indonesia mengenai hubungan Ejection Fraction (EF) dengan fungsi ginjal. Metode: Penelitian ini merupakan penelitian cross-sectional yang mengikutsertakan pasien gagal jantung di RSUP Dr. Cipto Mangunkusomo tahun 2018 – 2020 sebagai populasi sasaran. Uji Chi-squared digunakan untuk menganalisis korelasi antar variabel. Izin etik diperoleh karena penelitian ini menggunakan manusia sebagai subjeknya. Hasil: Sebanyak 158 subjek diikutsertakan dalam penelitian ini setelah menerapkan kriteria inklusi dan eksklusi. Terdapat 37 (36,6%) pasien HF pada kelompok HFrEF yang memiliki eGFR stadium 3, 4, atau 5. Sedangkan di kelompok HFmrEF atau HFpEF, terdapat 29 (50,9%) dengan eGFR stadium 3, 4 , atau 5 (p-value = 0,115, RR = 0,72). Pasien gagal jantung dengan eGFR stadium 3, 4, atau 5 (n = 8;12,1%) dan eGFR stadium 1 atau 2 (n = 4; 4,3%) termasuk dalam kelompok NYHA kelas III atau IV (p-value = 0,125, RR = 2,79). Kesimpulan: Tidak ada perbedaan proporsi pasien HFrEF dengan HFpEF untuk memiliki eGFR stadium 3, 4, atau 5 serta proporsi pasien HF yang eGFR stadium 3,4 atau 5 dengan eGFR stadium 1 atau 2 untuk dimasukkan pada kelompok NYHA kelas III atau IV.

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Background: Heart failure is considered one of leading cause of death In Indonesia. The heart and kidneys are tightly related which can be explained by the cardiorenal syndrome. There is a paucity of current data in a tertiary hospital in Indonesia regarding the association of Ejection Fraction (EF) with kidney function. Method: This is a cross-sectional study that includes heart failure patients in Dr. Cipto Mangunkusomo Hospital year 2018 – 2020 as the target population. The Chi-squared test is used to analyse the association between the variables. Ethical permission was obtained since this research used humans as the subject. Results: A total of 158 subjects were included in this study after applying the inclusion and exclusion criteria. There were 37 (36,6%) HF patients in the HFrEF group had eGFR stage 3, 4, or 5. Meanwhile, among HFmreEF or HFpEF group, there were 29 (50,9%) with eGFR stage 3, 4, or 5 (p-value = 0,115, RR = 0,72). HF patients in both eGFR stage 3, 4, or 5 (n = 8;12,1%) and eGFR stage 1 or 2 (n = 4; 4,3%) were included in the NYHA class III or IV group (p-value = 0,125, RR = 2,79). Conclusion: There are no differences in the proportion of HFrEF patients with HFpEF to have eGFR stage 3, 4, or 5 as well as in the proportion of HF patients whose eGFR stages 3,4 or 5 with eGFR stages 1 or 2 to be included in the NYHA class III or IV group. "

"Jumlah penduduk kota yang semakin banyak akan menyebabkan banyak hal salah satunya ancaman dari penyakit tidak menular yang begitu banyak terjadi. Salah satu penyakit menular yang banyak terjadi adalah gagal jantung. Gagal jantung yang merupakan penyakit kronik akan menimbulkan masalah psikologis salah satunya ketidakberdayaan. Penulisan Karya Ilmiah Akhir Ners ini bertujuan untuk memberikan analisis asuhan keperawatan ketidakberdayaan pada klien dengan gagal jantung. Penulis melakukan asuhan keperawatan psikososial khususnya ketidakberdayaan selama tiga hari.Evaluasi hasil implementasi menunjukkan bahwa terjadi sedikit penurunan tanda dan gejala yang terjadi pada klien. Perlu dilakukan kolaborasi intervensi generalis dan spesialis agar didapatkan hasil yang lebih optimal.

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The population of the town that more and more will cause a lot of things one of them the threat of non-communicable diseases. One of non-communicable diseases which are heart failure. Heart failure is a chronic disease that will lead to psychological problems is one of powerlessness. The author conducted a powerlessness psychosocial nursing care for three days. Evaluation of the results of implementation shows that there is a slight decrease in the signs and symptoms that occurred on the client. Need to do interventions collaboration generalists and specialists to get optimal results for patient."

"Latar belakang: Pasien gagal jantung dengan penurunan fraksi ejeksi memiliki angka readmisi yang lebih tinggi dibandingkan dengan fraksi ejeksi normal, dan angka readmisi paling tinggi pada 30-hari pertama pascakeluar admisi sebelumnya. Sekitar 30% pasien dengan gagal jantung juga mengalami Diabetes Melitus (DM) Tipe-2. Sejauh ini, belum ada prediktor kejadian readmisi dalam 30-hari pada pasien dengan populasi tersebut di RSJPDHK, khususnya prediktor dari sisi klinis dan metabolik.Tujuan: Mengetahui prediktor klinis dan metabolik terhadap kejadian readmisi dalam 30-hari pada pasien Gagal Jantung Dekompensasi Akut (GJDA) dengan penurunan fraksi ejeksi dan DM tipe-2.Metode: Studi dilakukan secara kohort retrospektif, data diambil dari rekam medis berdasarkan admisi pasien yang memenuhi kriteria inklusi antara Januari 2016-Januari 2021. Luaran klinis terbagi menjadi kelompok readmisi dan kelompok non-readmisi. Luaran klinis yang dinilai adalah kejadian readmisi akibat perburukan kondisi gagal jantung pada 30-hari pascaadmisi terakhir di RSJPDHK. Dilakukan analisis multivariat untuk menentukan prediktor yang bermakna menentukan readmisi dalam 30-hariHasil: Dari total 747 subjek penelitian, 179 subjek termasuk ke dalam kelompok readmisi, dan 568 subjek termasuk ke dalam kelompok non-readmisi (angka readmisi 24%). Analisis regresi logistik multivariat menunjukkan bahwa faktor-faktor yang berhubungan dengan kejadian readmisi dalam 30-hari adalah: irama fibrilasi atrium (OR 2.616; 95% IK: 1.604-4.267; p 0.000), serta denyut jantung saat pulang rawat (OR 1.022; 95% IK: 1.005-1.039; p 0.010). Kadar gula darah post-prandial < 140 mg/dL menjadi prediktor protektif untuk kejadian readmisi dalam 30-hari (OR 0.528; 95% IK: 0.348-0.802; p 0.003).Kesimpulan: Dua faktor klinis yaitu irama fibrilasi atrium dan denyut jantung saat akhir masa rawat menjadi prediktor readmisi yang bermakna terhadap kejadian readmisi dalam 30-hari akibat perburukan kondisi gagal jantung, sedangkan kadar gula darah post-prandial < 140 mg/dL menjadi faktor protektif untuk kejadian readmisi 30-hari pada populasi pasien gagal jantung dengan penurunan fraksi ejeksi dan DM tipe-2.

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Background: Patients Heart Failure with reduced Ejection Fraction (HFrEF) had higher readmission rates than normal ejection fractions, and readmission rates were highest in the first 30-days post-admission. About 30% of patients with heart failure also have Type-2 Diabetes Mellitus (DM). So far, there is no predictors for the incidence of 30-days readmission in patients with this kind of population in National Cardiovascular Centre Harapan Kita (NCCHK).

Objective: To determine the clinical and metabolic predictors of 30-days readmission in patients with Acute Decompensated Heart Failure (ADHF) with reduced ejection fraction and type-2 DM.

Methods: The study was conducted in a retrospective-cohort, data were taken from medical records based on admissions of patients who met the inclusion criteria between January 2016-January 2021. The clinical outcomes were divided into readmission and non-readmission groups. The clinical outcome assessed was the incidence of readmission due to worsening of the condition of heart failure at 30-days after the last admission at NCCHK. Multivariate analysis was performed to determine significant predictors for 30-day readmission.

Result: Of the total 747 research subjects, 179 subjects were included in the readmission group, and 568 subjects included in the non-readmission group (readmission rate 24%). Multivariate logistic regression analysis showed that the factors associated at 30-days readmission were: atrial fibrillation rhythm (OR 2.616; 95% CI: 1.604-4,267; p 0.000), heart rate at discharge (OR 1.022; 95% CI: 1.005-1.039; p 0.010). Post-prandial blood glucose level < 140 mg/dL was a protective predictor for 30-day readmission (OR 0.528; 95% CI: 0.348-0.802; p 0.003).

Conclusions: Two clinical factors, namely atrial fibrillation and heart rate at the end of hospitalization, were significant predictors of readmission in 30 days due to worsening of heart failure, while postprandial blood sugar levels < 140 mg/dL were protective factors for 30-days readmission in population of heart failure with reduced ejection fraction and type-2 DM."

"Latar Belakang: Infeksi COVID-19 merupakan penyakit dengan komplikasi multi-organ, salah satunya komplikasi kardiovaskular. Dengan kejadian gagal jantung akut sebagai komplikasi COVID-19 dengan mortalitas dan morbiditas yang tinggi, perlu dilakukan identifikasi faktor-faktor yang berhubungan dengan terjadinya gagal jantung akut pada pasien COVID-19, khususnya pada derajat sedang – berat.Tujuan : Mengetahui prediktor gagal jantung akut pada pasien COVID-19 yang dirawat, khususnya derajat sedang – beratMetode : Metode penelitian bersifat kohort retrospektif. Luaran primer adalah kejadian gagal jantung akut saat perawatan. Terdapat 15 faktor klinis dan laboratoris yang dianalisis secara bivariat dan multivariat.Hasil: Dari total 208 subjek sesuai kriteria inklusi dan eksklusi, sebanyak 73 subjek (35%) mengalami episode gagal jantung akut saat perawatan. Riwayat gagal jantung kronik memiliki risiko 5,39 kali (95% IK: 1,76 – 16,51; p = 0,003) mengalami kejadian gagal jantung akut. Pasien dengan nilai TAPSE < 17 mm memiliki risiko 4,25 kali (95% IK: 1,13 – 16,07; p= 0,033) mengalami gagal jantung akut. Sedangkan pemakaian ACE-i/ARB memiliki risiko 0,16 kali (95% IK: 0,05 – 0,51; p = 0,002) untuk mengalami gagal jantung akut intraperawatan dibandingkan kelompok tanpa pemakaian ACE-i/ARB.Kesimpulan: Riwayat gagal jantung kronik, TAPSE < 17 mm, dan pemakaian ACE-i/ARB diidentifikasi sebagai prediktor kejadian gagal jantung akut pada pasien COVID-19.

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Introduction: COVID-19 infection is a disease with multi-organ complications, including cardiovascular organ. As heart failure is one of COVID – 19 complications that has high morbidity and mortality, we need to identify factors that can predict acute heart failure in COVID – 19, especially in moderate to severe patients.

Objective : to determine predictors of acute heart failure in hospitalized COVID -19 patients

Method : This was a retrospective cohort study. The primary outcome was acute heart failure that happened during hospitalization. There were total of 16 clinical (age, sex, body mass index, hypertension, diabetes, smoking history, coronary artery disease, chronic kidney disease, chronic heart failure, chronic obstructive pulmonary disease, PaO2/FiO2 ratio, non-cardiogenic shock at admission, use of ACE-inhibitors/ARBs during hospitalization, ejection fraction, TAPSE) as well as 6 laboratory parameters (neutrophil - lymphocyte ratio, platelet - lymphocyte ratio, eGFR, D-Dimer, procalcitonin, CRP) that were used in statistical analysis.

Result: From total of 208 subjects with moderate – severe COVID-19, 73 (35%) had acute heart failure. The median time of developing heart failure is 4 ( 1 - 27) days. On multivariate analysis, patients with history of chronic heart failure exhibited a 5.39-fold higher risk of acute heart failure compared with no history of chronic heart failure (95% CI: 1.76 – 16.51; p = 0.003). The risk of acute heart failure was multiplied by 4.25 in patients that was presented with TAPSE <17 mm (95% CI: 1.13 – 16.07; p= 0.033). In contrast, use/continuation of ACE-inhibitors/angiotensin receptor blockers during hospitalization showed reduced risk of acute heart failure (16% of the risk developing acute heart failure compared with patients with no use of ACE-inhibitors/angiotensin receptor blockers). In subjects developing acute heart failure, the mortality rate was 67%, compared with 57% in subjects without acute heart failure (p = 0,028).

Conclusion: History of chronic heart failure, TAPSE <17 mm, and the use of ACE-inhibitors/angiotensin receptor blockers were identified as predictors of acute heart failure in hospitalized COVID-19 patients."

"Latar belakang: Penyakit jantung menjadi salah satu penyakit kronik yang menjadi masalah utama. Gagal jantung merupakan satu masalah penting di antara penyakit jantung. Rehospitalisasi orang gagal jantung berdampak terhadap bertambahnya beban biaya perawatan kesehatan, serta menyebabkan peningkatan risiko kematian. Tujuan: Meneliti pengaruh komorbiditas terhadap rehospitalisasi dini orang dengan gagal jantung dalam 30 hari setelah keluar rawat inap pertama. Desain: Kohort retrospektif berbasis Heart Failure Registry di klinik khusus gagal jantung Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita Jakarta periode Oktober 2009-Oktober 2010, dengan total sampel 147 orang. Hasil: Rehospitalisasi dini atau rehospitalisasi dalam 30 hari pertama setelah keluar rawat inap pertama sebesar 18,7%. Komorbiditas berpengaruh terhadap rehospitalisasi dini. Ada perbedaan efek antara laki-laki dan perempuan dengan gagal jantung. Odds rasio laki-laki tanpa atau dengan satu komorbiditas sebesar 3,1 (95% CI:0,8-11,6) lebih tinggi daripada odds rasio perempuan tanpa atau dengan satu komorbiditas dan juga yang lebih dari satu komorbiditas 2,6 (95%CI:0,4-17,9). Ketika laki-laki disertai lebih dari satu komorbiditas odds rasio meningkat menjadi 4,1 (95% CI:0,97-16,96). Kesimpulan: Pengaruh komorbiditas terhadap rehospitalisasi dini berbeda antara laki-laki dan perempuan dengan gagal jantung. Peningkatan risiko rehospitalisasi dini lebih tinggi pada laki-laki dan meningkat seiring jumlah komorbiditas.

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Background: Heart disease is one of main problems for chronic disease in Indonesia. Unfortunately, heart failure is the one important problem among heart diseases. Rehospitalized of heart failure patient made additional burden health care costs, and also early rehospitalization lead to increasing mortality risk.

Objectives: To study the comorbidities effect on early rehospitalization of heart failure within 30 days after discharge from first hospitalization.

Methods: Using Heart Failure Registry of Harapan kita Hosiptal, the study select all 147 cohort who first time hopitalized within October 2009-Oktober 2010.

Results: Early rehospitalization or rehospitalization in 30 days after discharge is 18,7%. Comorbidity is associated with early rehospitalization. There are different effect of comorbidies between male and female. Odds ratio of male without or with one comorbidity of 3.1 (95% CI :0.8-11.6) is higher than the odds ratio of female without or with one comorbidity and also that more than one comorbidity 2.6 (95 % CI :0,4-17, 9). When a male with more than one comorbidity increased the odds ratio to 4.1 (95% CI :0,97-16, 96).

Conlusion: Comorbidity effect on early rehospitalization is different among gender differences The increasing of early rehospitalization risk among male is higher and concomitant with the number of comorbidities."