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"ABSTRAKPemberian edukasi terkait Pola hidup merupakan salah satu intervensi keperawatan yang dapat diberikan pada klien post PCI dalam mencegah terjadinya kejadian nyeri dada kardiak berulang. Penelitian ini bertujuan untuk mengidentifikasi hubungan karakteristik dan pola hidup terhadap kejadian nyeri dada kardiak berulang pada klien post PCI dengan menggunakan metode survei analitik pendekatan cross sectional. Sampel berjumlah 110 klien post PCI. Teknik sampling yang digunakan adalah purposive sampling. Responden mengisi kuesioner berupa data demografi, kejadian nyeri dada kardiak berulang, dan 20 pertanyaan tentang pola hidup. Hasil penelitian menunjukan adanya hubungan antara pola hidup dengan kejadian nyeri dada kardiak berulang post PCI dengan nilai p < 0,05 (p=0,001). Penelitian ini bermanfaat bagi pelayanan keperawatan dalam mengevaluasi terjadinya penyumbatan kembali pembuluh darah yang menyebabkan nyeri dada berulang sehingga dapat memberikan ataupun menyusun strategi dalam memodifikasi intervensi keperawatan untuk mengurangi kejadian nyeri dada berulang, dan dapat meningkatkan status kemampuan fungsional pada klien post PCI.

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ABSTRACT

Pattern of life or lifestyle is one of the nursing interventions that can be given to post PCI clients in preventing the occurrence of recurrent cardiac chest pain. This study aims to identify the relationship of characteristics and lifestyle to the incidence of recurrent cardiac chest pain in post PCI clients by using cross sectional analytical survey method. The sample numbered 110 post PCI clients. The sampling technique used is purposive sampling. Respondents fill out questionnaires in the form of demographic data, incidence of recurrent cardiac chest pain, and 20 questions about lifestyle. This study was analyzed using Chi square test, independent T-Test and mann whitney test. The result of this research showed that there was a correlation between the age and the incidence of recurrent cardiac chest pain post PCI (0,03), there was a correlation the history of diabetes of the respondent and the incidence of recurrent cardiac chest pain post PCI (0001), the correlation between frequency of PCI and the incidence of recurrent cardiac chest pain post PCI (0.03), and the lifestyle relation with recurrent cardiac chest pain post PCI (p = 0.001). Further research may require adding an independent variable that affects the occurrence of recurrent pain in post PCI clients or specifying research topics such as factors that affect the incidence of recurrent chest pain in post PCI clients. This study is useful for nursing services in evaluating the occurrence of blockage of blood vessels that cause chest pain, can provide or develop strategies in modifying nursing interventions to reduce the incidence of recurrent chest pain in post PCI clients, in order to improve functional ability status in post PCI clients.

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"Intervensi yang dilakukan untuk Penyakit jantung Koroner (PJK) adalah reperfusi miokard dengan tindakan Percutaneous Coronary Intervention (PCI). Namun paska tindakan PCI dapat terjadi risiko infark miokard dan restenosis sehingga kepatuhan perawatan diri penting pada pasien Post PCI. Penelitian ini bertujuan untuk mengidentifikasi faktor faktor yang berhubungan dengan kepatuhan perawatan diri pada pasien Post PCI. Desain penelitian ini menggunakan desain non eksperimental jenis cross sectional. Responden sebanyak 90 orang yang diperoleh melalui teknik consecutive sampling. Analisa data yang dilakukan secara univariat, bivariat dan multivariat (regresi logistik). Hasil penelitian menunjukkan bahwa faktor yang berhubungan dengan kepatuhan perawatan diri secara signifikan adalah usia (p= 0.05, α=0.05), jaminan kesehatan (p= 0.020, α=0.05), dukungan keluarga (p=<0.001, α=0.05), keyakinan terhadap pengobatan (p= 0.018, α=0.05) dan motivasi (p=0.032, α=0.05). Sedangkan pada analisa multivariat, faktor yang paling berhubungan dengan kepatuhan perawatan diri Post PCI adalah dukungan keluarga. Implikasi dalam keperawatan adalah memberikan edukasi yang sesuai dengan kebutuhan pasien dengan melakukan skrining sebelumnya dan melibatkan keluarga dalam pemberian edukasi

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The intervention for coronary heart disease (CHD) is myocardial reperfusion with Percutaneous Coronary Intervention (PCI). However after PCI, there are a lot of risk such as myocardial infarction and restenosis, so self-care adherence is important for patients after PCI. This study aimed to identify factors related with self-care adherence in post-PCI patients. A non-experimental design with cross-sectional approach was used in this research. while 90 respondents were obtained through consecutive sampling technique. Data analysis was using univariate, bivariate and multivariate (logistical regression). The results showed that age (p= 0.05, α=0.05), health insurance (p= 0.020, α=0.05), family support (p=<0.001, α=0.05), medication beliefs (p=0.018, α=0.05) and motivation (p=0.032, α=0.05) had significant relationship with self care adherence. Family support was the dominant factor associated with self care adherence. Implication for nursing is providing education that focused on patient’s needs by performing screening and involving family in providing education."

"In-stent restenosis adalah komplikasi yang dapat terjadi setelah pemasangan stent. Penelitian ini bertujuan untuk mengidentifikasi faktor ? faktor yang berhubungan dengan tindakan PCI berulang. Desain penelitian menggunakan desain non eksperimental jenis cross sectional. Responden sebanyak 70 orang, diperoleh melalui teknik consecutive sampling. Analisis data dilakukan secara univariat, bivariat (chi square) serta multivariat (regresi logistik berganda). Hasil penelitian menunjukkan bahwa riwayat merokok memiliki hubungan yang signifikan dan merupakan faktor dominan dengan tindakan PCI berulang. Implikasi dalam keperawatan adalah peningkatan peran perawat sebagai pendidik dalam memberikan pendidikan kesehatan tentang pengendalian faktor risiko yakni kebiasaan merokok pada pasien yang terpasang stent dalam mencegah in-stent restenosis.

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In-stent restenosis is a complication that can occur after stenting. This study aimed to identify factors related to re-PCI. A non-experimental design with cross sectional approach was used in this research, while 70 respondents were obtained through a consecutive sampling technique. Data analyzed was performed using univariate, bivariate (chi square) and multivariate (multiple logistic regression) tests.

The results showed that a history of smoking has a significant relationship with the re-PCI and history of smoking is the dominant factor associated with re-PCI. Implications of the research to nursing is to improve of the role of nurses as educators in providing health education to control risk factors, especially smoking habits in patients who mounted stents in order to prevent in-stent restenosis."

"Menurut Institute of Health Metrics and Evaluation (IHMEI) pada tahun 2017, gangguan depresi dan cemas berada di posisi paling atas dalam menyebabkan terjadinya disabilitas. Sementara itu, penyakit kardiovaskular adalah penyebab kematian nomor satu secara global dan di Asia Tenggara sampai saat ini. Salah satu penyakit kardiovaskular yang umum ditemukan pada layanan kesehatan adalah Sindroma Koroner Akut. Terdapat banyak faktor risiko yang dapat memperburuk Sindroma Koroner Akut, salah satunya adalah faktor psikologis yang mencakup cemas dan depresi. Oleh sebab itu, perlu dilakukan penelitian yang menelaah hubungan cemas dan depresi terhadap Sindroma Koroner Akut pasca intervensi koroner perkutan untuk mewujudkan tatalaksana Sindroma Koroner Akut yang komprehensif. Penelitian dilakukan menggunakan desain penelitian analitik observasional dengan rancangan studi kohort prospektif. Penelitian menggunakan sampel sebanyak 50 subjek dengan Sindrom Koroner Akut atau Kronik yang menjalani intervensi koroner perkutan di RSUP Nasional dr. Cipto Mangunkusumo serta RS Jantung Jakarta. Kondisi subjek penelitian dinilai menggunakan beberapa instrumen: HAM-D untuk pengukuran gejala depresi, HAM-A untuk pengukuran gejala cemas, skoring Canadian Cardiovascular Society untuk pengukuran derajat gejala Sindrom Koroner Akut dan Kronik, dan pengukuran TIMI Flow untuk pengukuran sumbatan pada pembuluh darah jantung. Analisis multivariat regresi logistik dilakukan untuk mengetahui kekuatan hubungan faktor demografi, psikologis, dan medik serta derajat depresi dan cemas pada kasus Sindrom Koroner Akut dan Kronik terhadap perbaikan pasca intervensi koroner perkutan. Dari 50 subjek, sebanyak 92,0% mengalami gejala cemas dan sebanyak 50,0% mengalami gejala depresi sebelum menjalani intervensi koroner perkutan. Setelah tindakan turun menjadi 18% mengalami gejala cemas dan 10% ada gejala depresi. Pada penelitian ini, tidak ditemukan hubungan bermakna antara gejala cemas dan depresi pra intervensi koroner perkutan dengan perbaikan yang dirasakan pasca intervensi koroner perkutan. Analisis multivariat menemukan tidak menikah/bercerai berperan (p = 0,012; OR = 13,449; IK = 1,753 – 103,184) sebagai faktor risiko terhadap tidak mengalami perbaikan setelah intervensi koroner perkutan pada kasus Sindrom Koroner Akut dan Kronik.

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According to the Institute of Health Metrics and Evaluation (IHMEI) in 2017, anxiety and depressive disorders were the most prominent cause of disability. On the other hand, cardiovascular diseases are the highest cause of death in global and Southeast Asia until now. One of the most common cardiovascular diseases found in healthcare services is Acute Coronary Syndrome. Numerous factors play a role in the worsening of Acute Coronary Syndrome, one of such factors is psychological factors, including anxiety and depression. Therefore, study targeting the relationship of anxiety and depressive symptoms towards Acute Coronary Syndrome post PCI is needed to establish a comprehensive treatment of Acute Coronary Syndrome. Research is done in observational analytical design with prospective cohort study design. Research data is gathered from 50 patients with Acute or Chronic Coronary Syndrome who underwent percutaneous coronary intervention in Cipto Mangunkusumo National Referral Hospital and Jakarta Heart Hospital. Subjects have their conditions assessed by using several instruments: HAM-D to measure depression severity, HAM-A to measure anxiety severity, Canadian Cardiovascular Society scoring to measure severity of Acute or Chronic Coronary Syndrome and TIMI Flow measurement to examine the occlusion in coronary arteries. Logistic regression multivariate analysis was utilized to examine the implication of demographic, psychological, medical factors and depression and anxiety severity in Acute and Chronic Coronary Syndrome cases towards improvement felt post percutaneous coronary intervention. Out of 50 subjects, 92,0% had anxiety symptoms and 50,0% had depression symptoms before they had percutaneous coronary intervention. After intervention this number decreased to 18% had anxiety and 10% still had depression symptoms. No significant relationship was found between anxiety and depression symptoms pre-PCI with improvement felt post-PCI. Multivariate analysis found that being not married/divorced (p = 0,012; OR = 13,449; CI = 1,753 – 103,184) as a risk factor towards not feeling any improvement post-PCI."

"Latar Belakang : Setengah pasien IMA-EST yang menjalani intervensi koroner perkutan primer(IKPP) memiliki multivessel disease. Rekomendasi saat ini hanya menganjurkan intervensi pada arteri terkait infark pada saat IKPP. Revaskularisasi selanjutnya pada stenosis signifikan lainnya dapat dilakukan dengan intervensi koroner perkutan (IKP) atau bedah pintas arteri koroner (BPAK). Namun sampai saat ini belum ada panduan pemilihan tindakan paska IKPP dengan multivessel disease. Tujuan : Mendapatkan data yang akurat tentang mortalitas IKP dan BPAK pada stenosis multipel paska IKPP. Melalui data ini diharapkan didapatkan rekomendasi yang sesuai tentang pilihan strategi pada stenosis multipel paska IKPP. Metode : Penelitian ini merupakan studi kohort retrospektif observasional. Penelitian dilakukan di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK) dengan mengambil data dari rekam medis. Durasi data yang diambil dari 01 Januari 2011 - 31 Desember 2014. Data karakteristik dasar, data klinis, dan angiografi dicatat dari rekam medis dan melalui wawancara melalui telepon. Data kemudian diolah dengan analisis bivariat dan multivariat untuk melihat hubungan kedua jenis tindakan dan mortalitas. Hasil Penelitian : Terdapat 177 pasien yang memenuhi kriteria dengan 141 pasien yang dilakukan IKP dan 36 pasien dilakukan BPAK paska IKPP. Karakteristik dasar tidak berbeda diantara kedua kelompok. Data klinis dan angiografi menunjukkan perbedaan culprit lesion (p=0,007), residual lesion (p<0,001), dan jumlah vessel (p<0,001). Data pre tindakan ulang menunjukkan perbedaan interval waktu tindakan (p=0,042) dan lesi Left Main (LM) atau proksimal left anterior descending (LAD) (p=0,032). Mortalitas terjadi pada 14,2% pada kelompok IKP dan 27,8% pada kelompok BPAK (RR 1,96; 95% IK 1,01-3,81). Hasil analisis bivariat menunjukkan bahwa diabetes mellitus (RR 1,18; 95% IK 1,03-1,36), fraksi ejeksi (RR 1,18; 95% IK 1,01-1,38), lesi residual LM atau proksimal LAD (RR 2,43; 95% IK 1,08-5,48), dan nilai kreatinin saat tindakan ulang (p=0,027) memiliki pengaruh terhadap mortalitas selain BPAK. Hasil multivariat regresi logistik biner dan cox regression didapatkan bahwa DM (aOR 2,67; 95% IK 1,145-6,248), lesi LM atau proksimal LAD (aOR 2,49; 95% IK 1,078-5,762), dan fraksi ejeksi (aOR 2,43; 95% IK 1,067-5,567) yang berpengaruh terhadap mortalitas. Kesimpulan : Mortalitas BPAK dan IKP tidak berbeda secara statistik pada pasien paska IKPP dengan multivessel disease. Perbedaan angka mortalitas disebabkan karena adanya perbedaan lesi residual pada LM atau proksimal LAD yang dari awal merupakan karakteristik pre tindakan ulang yang berbeda diantara kedua kelompok. DM dan fraksi ejeksi konsisten menyebabkan mortalitas pada kedua kelompok dan tidak berbeda bermakna pada kedua kelompok.

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Background : Almost half of the patients with STEMI that undergo Primary Percutaneous Coronary Intervention (PPCI) have multivessel disease. Currently, the only recommendation is to intervene in the infarct related artery at the time of PPCI. The next revascularization on other significant stenosis can be done with Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG). However, the guideline in selecting intervention post PPCI with multivessel disease is currently unavailable.

Objective : To obtain accurate data of mortality in PCI and CABG on patient with multivessel disease post PPCI. The data is expected to obtain reasonable recommendation of selection strategy on multiple stenosis post PPCI.

Methods : This study is an observational retrospective cohort. The research was done by retrieving medical record data of catheterization laboratory divison at the Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK) from 1st January 2011 to 31st December 2014. Basic characteristics data, clinical data, and angiography were recorded from medical records and interviewes through telephone. The data is then processed by bivariate and multivariate analyzes to obtain the relationship between two types of modality and mortality.

Results : There were 177 eligible post PPCI patients, 141 patients undergoing PCI and 36 patients undergoing CABG. The baseline characteristics are no different between the two groups. Clinical data and angiography show a difference culprit lesion (p = 0.007), residual lesions (p<0.001), and the number of vessel (p <0.001). Pre intervention data shows the intervention time interval difference (p = 0.042) and the Left Main lesion (LM) or proximal left anterior descending (LAD) (p = 0.032). Mortality occurred in 14.2% and 27.8% in the PCI and CABG group (RR 1.96; 95% CI 1.01 to 3.81). The results of bivariate analyzes shows that diabetes mellitus (RR 1.18; 95% CI 1.03 to 1.36), ejection fraction (RR 1.18; 95% CI 1.01 to 1.38), residual lesions LM or proximal LAD (RR 2.43; 95% CI 1.08 to 5.48), and creatinine values before intervention (p = 0.027) had an significant influence on mortality other than CABG. The results of multivariate binary logistic regression and cox regression shows that DM (aOR 2.67; 95% CI 1.145 to 6.248), LM or proximal LAD lesion (aOR 2.49; 95% CI 1.078 to 5.762), and ejection fraction (aOR 2 , 43; 95% CI 1.067 to 5.567) effect on mortality.

Conclusion : Mortality in PCI and CABG were not statitically different for the post PPCI patients with multivessel disease. The difference on mortality was caused by the difference of residual lesions on the LM or proximal LAD which is the characteristic of different pre reintervention in the two types of modality. DM and the ejection fraction were consistently cause mortality in both groups and not significantly different in both groups."

"Penyakit jantung koroner hingga saat ini masih menjadi penyebab utama kematian di Indonesia. Untuk itu diperlukan diperlukan suatu metode pengobatan untuk menangani pasien dengan penyakit jantung koroner, salah satunya adalah metode Percutaneous coronary intervention (PCI). Penelitian ini bertujuan untuk membuat suatu panduan mengenai Bahan medis habis pakai (BMHP) yang digunakan dalam tindakan pada Percutaneous coronary intervention (PCI). Panduan ini khususnya diharapkan dapat menjadi panduan terutama bagi Apoteker dan Tenaga Teknis Kefarmasian (TTK) yang ada di Rumah Sakit Universitas Indonesia (RS UI). Penyusunan laporan panduan BMHP untuk tindakan PCI ini dilakukan melalui hasil pencarian studi literatur. Selain itu, dilakukan diskusi dan tanya jawab dengan ners cath lab dan apoteker yang bertugas di unit Farmasi OK RS UI terkait PCI dan bahan medis habis pakai (BMHP) apa saja yang digunakan ketika melakukan prosedur PCI. Hasil penyusunan laporan ini didapatkan berbagai jenis BMHP yang dibutuhkan demi kelancaran proses tindakan PCI, diantaranya: sheath, guidewire, stent, guide catheter, dan ballon catheter, yang masing-masing diantaranya terdiri dari jenis dan fungsinya yang berbeda-beda. Hasil penyusunan laporan ini dapat dijadikan sebagai panduan BMHP untuk tindakan PCI.

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Coronary heart disease is still the leading cause of death in Indonesia. For this reason, a treatment method is needed to deal with patients with coronary heart disease, one of which is the Percutaneous coronary intervention (PCI) method. This study aims to create a guide on medical consumables items used in the action of Percutaneous coronary intervention (PCI). This guide is especially expected to be a guide, especially for Pharmacists and Pharmaceutical Technical Personnel at the University of Indonesia Hospital. The preparation of the BMHP guidance report for PCI actions is carried out through the results of a literature study search. In addition, discussions and questions and answers were held with the CATH lab ners and pharmacists on duty at the OK of University of Indonesia Hospital Pharmacy unit regarding PCI and what medical consumables items are used when performing PCI procedures. The results of the preparation of this report obtained various types of medical consumables items needed for the process of PCI, including: sheath, guidewire, stent, guide catheter, and balloon catheter, each of which consists of different types and functions. The results of the preparation of this report can be used as a medical consumables items guide for PCI actions."

"Penelitian ini membahas tentang analisis risiko pada proses Percutaneous Coronary Intervention (PCI) di Rumah Sakit Jantung Binawaluya Tahun 2014. Tujuan penelitian ini adalah untuk mengetahui risiko dan tingkat risiko pada proses kegiatan tersebut. Metode identifikasi risiko menggunakan Task Risk Assesment, sedangkan untuk analisis risiko dilakukan dengan menggunakan metode analisis risiko semikuantitatif dengan kriteria penilaian risiko (consequence, likelihood, dan exposure). Penelitian ini adalah penelitian deskriptif analitik dengan menggunakan metode semi kuantitatif AS/NZS 4360:2004. Hasil analisis tingkat risiko yang didapatkan, yaitu risiko dengan tingkat risiko very high sebanyak 37, substantial sebanyak 2, priority 3 sebanyak 6. Saran yang dapat diberikan yaitu diperlukannya manajemen keselamatan dan kesehatan kerja di Rumah Sakit Jantung Binawaluya khususnya ruang Cathlab untuk membuat program keselamatan dan kesehatan kerja.

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This study discusses about risk analysis in Percutaneous Coronary Intervention (PCI) Process at Rumah Sakit Jantung Binawaluya in 2014. The purpose of this study was to determine the risk and level of risk in the PCI process. Risk identification method using the Task Risk Assesment, while for risk analysis is undertaken by semi-quantitative method that uses risk assessment criteria (consequence, likelihood, exposure). This study was a descriptive analytical study using semi-quantitative method AS/NZS 4360:2004. The results of the analysis of the obtained level of risk, is 37 risks to very high risk levels, 2 substantially risks, and 6 risks priority 3. Recommendation above this studi is to build safety and health management in Rumah Sakit Jantung Binawaluya, especially at Cathlab, by creating health and safety program."

"Percutaneous Coronary Intervention (PCI) adalah suatu tindakan intervensi non bedah dengan menggunakan kateter untuk melebarkan atau membuka pembuluh koroner yang menyempit dengan balon dan dilanjutkan dengan pemasangan stent agar pembuluh darah tetap terbuka. Proses penyempitan pembuluh darah koroner ini dapat disebabkan proses aterosklerosis atau thrombosis. PCI merupakan suatu tindakan yang biayanya relatif mahal. Hal ini terkait dengan sumber daya manusia yang terlibat, bahan habis pakai yang digunakan dan penggunaan alat-alat medik. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang terkait dengan biaya perawatan pasien dengan tindakan PCI di RSUP Fatmawati. Penelitian ini merupakan penelitian cross sectional dengan pendekatan kuantitatif melalui telaah data Sistem Informasi Rumah Sakit (SIRS), billing dan unit cost dan pendekatan kualitatif melalui wawancara mendalam. Hasil penelitian menunjukkan bahwa rata-rata biaya perawatan untuk tindakan PCI di RSUP Fatmawati pada tahun 2017 adalah sebesar Rp 53.629.532, dan komponen biaya terbesar dari total biaya perawatan tindakan PCI adalah biaya tindakan intervensi PCI, yaitu 82,8%. Hasil uji statistik menunjukkan bahwa variabel yang berpengaruh terhadap biaya perawatan adalah tingkat keparahan penyakit, lama hari rawat, penggunaan ICCU dan jumlah stent, sedangkan kelas perawatan, jumlah oklusi pembuluh darah dan kasus elektif tidak berpengaruh terhadap total biaya perawatan.

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Percutaneous Coronary Intervention is a nonsurgical intervention procedure by using a catheter to dilate or open coronary vessels that are narrow with balloons and followed by stent replacement to keep blood vessels open. The process of narrowing of these coronary arteries can be due to the process of atherosclerosis or thrombosis. PCI is an procedure that is relatively expensive. It is related to the human resources involved, the consumabled used and the used of medical devices.

This study aims to analyse the factors associated with patient care costs with PCI procedure at Fatmawati General Hospital. This cross sectional study was conducted quantitatively through hospital information system, billing and unit cost, and qualitatively through in-depth interview.

The results show that the average cost for PCI procedure at Fatmawati General Hospital in 2017 was Rp 53,629,532 and the largest cost component of total PCI cost was the cost of PCI intervention measure of 82,8%. The statistic results showed that the variables severity level, length of stay, use of ICCU and number of stents are correlated with total costs of procedure PCI, but variable room class, blood vessel occlusion and elective cases is not correlated to total cost of PCI."

"Tirah baring dan imobilisasi berkepanjangan pasca percutaneous coronary intervention (PCI) erat kaitannya dengan berbagai komplikasi dan prevalensi mortalitas yang tinggi di rumah sakit. Salah satu internvesi keperawatan yang dapat dilakukan untuk mencegah komplikasi akibat tirah baring pasca PCI adalah mobilisasi dini. Studi kasus dilakukan pada perempuan usia 60 tahun dengan NSTEMI. Dalam upaya untuk mempercepat pemulihan pascabedah, penulis menerapkan intervensi mobilisasi dini pada pasien. Pola mobilisasi yang diklasifikasikan sebagai tirah baring, semi-fowler, duduk, perpindahan ke kursi, dan berdiri/berjalan didokumentasikan oleh perawat selama pemberian asuhan. Intervensi dilakukan dalam 5 hari, sejak pra-PCI hingga 2 hari pasca PCI. Penulis menganalisis terhadap proses asuhan keperawatan mencakup analisis penerapan intervensi mobilisasi dini. Hasil evaluasi setelah penerapan intervensi mobilisasi dini antara lain peningkatan skala mobilitas pasien, tidak ada sesak selama latihan mobilisasi, tidak ada peningkatan nyeri pasca PCI, tidak terjadi jatuh saat proses ambulasi, kekuatan otot dan rentang gerak pasien dipertahankan, serta tidak adanya komplikasi berat pasca PCI selama penerapan mobilisasi dini. Berdasarkan temuan tersebut, penerapan mobilisasi dini secara bertahap pasca PCI dapat meningkatkan tingkat mobilitas dan tidak menimbulkan komplikasi pada pasien.

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Bed rest and prolonged immobilization after percutaneous coronary intervention (PCI) are closely related to various complications and a high prevalence of mortality in hospital. One of the disease interventions that can be done to prevent complications due to bed rest after PCI is early mobilization. The case study was conducted on a 60 year old woman with NSTEMI. In an effort to speed up postoperative recovery, the authors implemented early mobilization interventions for patients. Movement patterns classified as bed rest, semi-Fowler's, sitting, transferring to a chair, and standing/walking were documented by the nurse during care delivery. The intervention was carried out within 5 days, from pre-PCI to 2 days post-PCI. The author analyzes the maintenance process including analysis of the implementation of early mobilization interventions. Evaluation results after implementing early mobilization interventions include an increase in the patient's mobility scale, no shortness of breath during mobilization exercises, no increase in pain after PCI, no falls during the ambulation process, the patient's muscle strength and range of motion are maintained, and the absence of severe complications after PCI during early mobilization. Based on these findings, gradual application of early mobilization after PCI can increase the level of mobility and not cause complications in patients."

"[ABSTRAKLatar Belakang : Kejadian mortalitas dan MACE merupakan komplikasi pasca PCI yang seringkali terjadi. Kemampuan ahli dalam memprediksi komplikasi dengan cara melakukan stratifikasi risiko menggunakan skor risiko. New Mayo Clinic Risk Score (NMCRS) menggunakan tujuh variabel yang mudah didapatkan pada data awal pasien dan memiliki performa yang baik. Belum ada studi untuk karakteristik mortalitas dan MACE pada NMCRS di ICCU RSCM.Tujuan : mengetahui insidens mortalitas dan MACE serta karakteristik NMCRS pada pasien pasca PCI selama perawatan di ICCU RSCM.Metode : Penelitian dengan desain kohort retrospektif terhadap 313 pasien SKA pasca PCI di ICCU RSCM, dalam kurun waktu 1 Agustus 2013? 31 Agustus 2014. Data pasien dari rekam medis dimasukkan ke dalam tujuh variabel skor NMCRS kemudian ditentukan hasil setiap kategori risiko.Hasil : Insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Pasien-pasien dengan usia yang semakin tua, fraksi ejeksi ventrikel kiri yang rendah, infark miokard, kreatinin serum yang meningkat, adanya syok kardiogenik pra prosedur, dan adanya penyakit arteri perifer memiliki kejadian mortalitas dan MACE yang lebih tinggi pasca PCI. Skor NMCRS untuk mortalitas menunjukkan kategori risiko sangat rendah 167 pasien (53%), risiko rendah 60 pasien (19%), sedang 47 pasien (15%), tinggi 10 pasien (3%) dan risiko sangat tinggi 29 pasien (9%). Kejadian mortalitas pada kategori risiko sangat rendah 2 kasus (1,2%), rendah 0 pasien, sedang 2 pasien (4,25%), tinggi 1 pasien (10%) dan sangat tinggi 7 kasus (24,13%). Skor NMCRS untuk MACE memberikan hasil kategori sangat rendah 101 pasien (32%), risiko rendah 128 pasien (41%), sedang 52 pasien (17%), tinggi 16 pasien (5%) dan sangat tinggi 16 kasus (5%). Kejadian MACE untuk risiko sangat rendah sebanyak 4 kasus (3,96%), rendah 7 pasien (5,46%), sedang 4 pasien (7,69%), tinggi 5 pasien (31,25%) dan risiko sangat tinggi 6 kasus (37,5%).Kesimpulan : insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Kenaikan skor NMCRS maka akan diiringi peningkatan kejadian mortalitas dan MACE pasca PCI.

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ABSTRACTBackground : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.;Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI., Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.]"