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"Imobilitas sering dijumpai pada pasien yang menjalani perawatan di rumah sakit, yang menyebabkan sulit dilakukan penimbangan. Kondisi lain seperti amputasi, organ tubuh tidak lengkap kongenital, tumor, pembesaran organ, kehamilan, edema atau asites, menyebabkan penimbangan berat badan tidak akurat. Berat badan diperlukan untuk menentukan kebutuhan energi, protein, cairan, serta pemantauan kecukupan tatalaksana nutrisi pada pasien, serta untuk perhitungan dosis obat dan fungsi ginjal. Formula berat badan estimasi telah dikembangkan dengan berbagai parameter antropometri, salah satunya Formula Cattermole yang menggunakan komponen lingkar lengan atas (LILA), dengan beberapa keuntungan yaitu mudah dan cepat dengan alat ukur yang efisien dan mudah dibawa. Penelitian ini merupakan studi potong lintang untuk mengetahui kesahihan rumus estimasi berat badan dengan berat badan (BB) aktual pada pasien rawat inap dewasa di RSUPN Dr.Cipto Mangunkusumo Jakarta (n=96). Didapatkan hasil rerata BB aktual 58,98 ± 13,80 kg, rerata BB estimasi berdasarkan LILA posisi tegak 60.1±17.28 kg, median BB estimasi berdasarkan LILA posisi baring 60.6 (21,2-114), beda rerata BB aktual dengan BB estimasi berdasarkan LILA posisi tegak -1.12 kg (p=0.16), beda rerata BB aktual dengan BB estimasi berdasarkan LILA posisi baring -1.38 (p=0.17). Dilakukan analisis Bland Altman, didapatkan limit of agreement (LOA) minimal dan maksimal berada di luar batas LOA 5 kg. Pola sebaran titik banyak di luar batas garis LOA baik minimal maupun maksimal pada kurva scatter plot Bland Altman. Sebagai kesimpulan, terdapat selisih antara berat badan estimasi menggunakan formula Cattermole dengan berat badan aktual, serta penelitian masih terbatas dilakukan pada pada pasien rawat inap di Indonesia. Fomula Cattermole belum dapat digunakan pada populasi umum di Indonesia. Diperlukan penelitian lebih lanjut pada populasi lain di Indonesia dengan kriteria subjek yang lebih beragam

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Immobility is often found in patients undergoing hospital treatment, which makes weighing difficult. Other conditions such as amputation, congenital incomplete organs, tumors, organ enlargement, pregnancy, edema or ascites, cause inaccurate weight measurement. Body weight is needed to determine energy, protein, fluid requirements, as well as monitoring the adequacy of nutritional management in patients, as well as for calculating drug doses and kidney function. The estimated body weight formula has been developed with various anthropometric parameters, one of which is the Cattermole Formula which uses the upper arm circumference component, with several advantages, namely being easy and fast with efficient and easy-to-carry measuring instruments. This study was a cross-sectional study to determine the validity of the formula for weight estimation with actual body weight in adult inpatients at Dr. Cipto Mangunkusumo Hospital Jakarta (n = 96). The results obtained mean actual body weight was 58.98 ±13.80 kg, mean estimated body weight based on upright MUAC was 60.1±17.28 kg, median estimated body weight based on supine MUAC was 60.6 (21.2-114) kg, the average difference is -1.12 kg (p=0.16) between actual body weight and estimated body weight based on upright MUAC and -1.38 (p=0.17) between actual body weight and estimated body weight based on supine MUAC. Bland Altman analysis was performed, limit of agreement (LOA) minimum and maximum, all outside the LOA limit of 5 kg. The distribution pattern of many points outside the LOA line on the Bland Altman scatter plot curve. In conclusion, there is a difference between the estimated body weight using the Cattermole formula and the actual body weight, and the research is still limited to inpatients in Indonesia. Cattermole formula can not be used in the general population in Indonesia. Further research is needed on other populations in Indonesia with more various subject criteria."

"Imobilitas sering dijumpai pada pasien yang menjalani perawatan di rumah sakit, yang menyebabkan sulit dilakukan penimbangan. Kondisi lain seperti amputasi, organ tubuh tidak lengkap kongenital, tumor, pembesaran organ, kehamilan, edema atau asites, menyebabkan penimbangan berat badan tidak akurat. Berat badan diperlukan untuk menentukan kebutuhan energi, protein, cairan, serta pemantauan kecukupan tatalaksana nutrisi pada pasien, serta untuk perhitungan dosis obat dan fungsi ginjal. Formula berat badan estimasi telah dikembangkan dengan berbagai parameter antropometri, salah satunya Formula Cattermole yang menggunakan komponen lingkar lengan atas (LILA), dengan beberapa keuntungan yaitu mudah dan cepat dengan alat ukur yang efisien dan mudah dibawa. Penelitian ini merupakan studi potong lintang untuk mengetahui kesahihan rumus estimasi berat badan dengan berat badan (BB) aktual pada pasien rawat inap dewasa di RSUPN Dr.Cipto Mangunkusumo Jakarta (n=96). Didapatkan hasil rerata BB aktual 58,98 ± 13,80 kg, rerata BB estimasi berdasarkan LILA posisi tegak 60.1±17.28 kg, median BB estimasi berdasarkan LILA posisi baring 60.6 (21,2-114), beda rerata BB aktual dengan BB estimasi berdasarkan LILA posisi tegak -1.12 kg (p=0.16), beda rerata BB aktual dengan BB estimasi berdasarkan LILA posisi baring -1.38 (p=0.17). Dilakukan analisis Bland Altman, didapatkan limit of agreement (LOA) minimal dan maksimal berada di luar batas LOA 5 kg. Pola sebaran titik banyak di luar batas garis LOA baik minimal maupun maksimal pada kurva scatter plot Bland Altman. Sebagai kesimpulan, terdapat selisih antara berat badan estimasi menggunakan formula Cattermole dengan berat badan aktual, serta penelitian masih terbatas dilakukan pada pada pasien rawat inap di Indonesia. Fomula Cattermole belum dapat digunakan pada populasi umum di Indonesia. Diperlukan penelitian lebih lanjut pada populasi lain di Indonesia dengan kriteria subjek yang lebih beragam

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Immobility is often found in patients undergoing hospital treatment, which makes weighing difficult. Other conditions such as amputation, congenital incomplete organs, tumors, organ enlargement, pregnancy, edema or ascites, cause inaccurate weight measurement. Body weight is needed to determine energy, protein, fluid requirements, as well as monitoring the adequacy of nutritional management in patients, as well as for calculating drug doses and kidney function. The estimated body weight formula has been developed with various anthropometric parameters, one of which is the Cattermole Formula which uses the upper arm circumference component, with several advantages, namely being easy and fast with efficient and easy-to-carry measuring instruments. This study was a cross-sectional study to determine the validity of the formula for weight estimation with actual body weight in adult inpatients at Dr. Cipto Mangunkusumo Hospital Jakarta (n = 96). The results obtained mean actual body weight was 58.98 ±13.80 kg, mean estimated body weight based on upright MUAC was 60.1±17.28 kg, median estimated body weight based on supine MUAC was 60.6 (21.2-114) kg, the average difference is -1.12 kg (p=0.16) between actual body weight and estimated body weight based on upright MUAC and -1.38 (p=0.17) between actual body weight and estimated body weight based on supine MUAC. Bland Altman analysis was performed, limit of agreement (LOA) minimum and maximum, all outside the LOA limit of 5 kg. The distribution pattern of many points outside the LOA line on the Bland Altman scatter plot curve. In conclusion, there is a difference between the estimated body weight using the Cattermole formula and the actual body weight, and the research is still limited to inpatients in Indonesia. Cattermole formula can not be used in the general population in Indonesia. Further research is needed on other populations in Indonesia with more various subject criteria."

"Penelitian ini mengenai karakteristik subjektif tidur pada klien rawat inap dewasa di Rumah Sakit Umum Daerah Depok. Desain penelitian ini deskriptif sederhana. Sampel yang terlibat berjumlah 72 pasien dengan teknik pengambilan sampel consecutive sampling. Responden mengisi kuesioner berisi skala tidur Verran dan Snyder-Halpern. Hasil penelitian didapatkan bahwa pasien mengalami gangguan tidur tingkat sedang (47,22%), hingga berat (25%). Efektivitas tidur pasien juga hanya berada pada tingkat sedang (50%), hingga rendah (19,44%). Pasien juga mensuplementasikan tidurnya dengan tingkatan sedang (38,88%), hingga tinggi (22%). Penelitian ini dapat digunakan sebagai penelitian dasar untuk meneliti faktor-faktor yang mempengaruhi pola tidur pasien rawat inap.

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This research was used simple descriptive design to explore subjective sleep characteristics of hospitalized adult patients in Depok Public Hospital. Consecutive sampling was applied on this research involving 72 patients. Patients were asked to fill the questionnaire about Verran and Snyder Halpern sleep scale (VSH Sleep Scale). Results showed that patients experienced sleep disturbance with moderate levels (47,22%), moreover (25%) patients experienced severe sleep disturbance. Patients felt that sleep effectiveness in moderate levels (50%), moreover (19,44%) only in low levels. Sleep supplementation also experienced by patients with moderate levels (38,88%), moreover (22%) in high levels. This research can be used as a pilot study to find out factors that affecting how patients sleep in the hospital environment."

"Cancer patients are at risk for having drug-related problems (DRPs) as they received concentrated electrolyte. This research aims to acquire characteristic descriptions also identify DRPs and their causes among hospitalized cancer patients receiving concentrated electrolyte in Dharmais Cancer Hospital. This is a descriptive research with cross-sectional design study. Data was collected retrospectively based on patients' prescriptions and laboratory results from January to March 2020 obtained from SIMRS. The DRPs were identified via Pharmaceutical Care Network Europe (PCNE) V6.2 and Lexicomp® was used to assess the drug-drug interactions. The data obtained were 159 study samples. The results illustrate that the sample characteristic consisted of 52.83% women and 47.17% men. The age of the patients consisted of 6.29% 19-29 years old, 10.69% 30-39 years old, 18.87% 40-49 years old, 33.96% 50-59 years old and 30.19 % 60 years old and above. The diagnosis of cancer was 98.74% classified as malignant cancer and 1.26% benign cancer. The condition of electrolyte disorder in hospitalized cancer patients consisted of 47.17% hyponatremia, 28.3% hypokalemia, and 24.53% metabolic acidosis. The results of DRPs identification showed that 75 patients (47.17%) had DRPs and 84 patients (52.83%) did not have DRPs. Types of DRPs that occurred was the Adverse Drug Reaction (64.97%) and the Drug Effectiveness (35.03%). Causes of DRPs was consisted of Drug Selection (84.08%) and Dose Selection (15.92%). Therefore, hospitalized cancer patients receiving concentrated electrolyte are susceptible to DRPs, so the review of prescription and therapy drug monitoring needs to be done carefully to reach the target therapy and improve patient safety.Pasien kanker berisiko mengalami masalah terkait obat (MTO) saat menggunakan elektrolit konsentrat. Penelitian ini bertujuan untuk memperoleh gambaran karakteristik dan mengidentifikasi jenis dan penyebab MTO pada pasien kanker rawat inap yang mendapat elektrolit pekat di Rumah Sakit Kanker Dharmais. Penelitian ini merupakan penelitian deskriptif dengan desain penelitian cross sectional. Pengumpulan data dilakukan secara retrospektif berdasarkan resep pasien dan hasil laboratorium periode Januari-Maret 2020 yang diperoleh dari SIMRS. Identifikasi MTO menggunakan klasifikasi Pharmaceutical Care Network Europe (PCNE) versi 6.2 dan Lexicomp® untuk menganalisis potensi interaksi obat-obat. Data yang diperoleh sebanyak 159 sampel penelitian. Hasil penelitian menunjukkan bahwa karakteristik sampel terdiri dari 54,09% perempuan dan 45,91% laki-laki. Rentang usia pasien terdiri dari 6,29% berusia 19-29 tahun, 10,69% berusia 30-39 tahun, 18,87% berusia 40-49 tahun, 33,96% berusia 50-59 tahun, dan 30,82%. berusia 60 tahun ke atas. 98,74% dari diagnosis kanker diklasifikasikan sebagai kanker ganas dan 1,26% adalah kanker jinak. Kondisi gangguan keseimbangan elektrolit pada pasien kanker rawat inap adalah hiponatremia 47,17%, hipokalemia 28,3%, dan asidosis metabolik 24,53%. Hasil identifikasi MTO menunjukkan sebanyak 75 pasien (47,17%) mengalami MTO dan 84 pasien (52,83%) tidak mengalami MTO. Jenis MTO yang terjadi adalah Reaksi Obat Tidak Diinginkan (ROTD) (64,97%) dan Masalah Efektivitas Terapi (35,03%). Penyebab MTO terdiri dari pemilihan obat (84.08%) dan pemilihan dosis (15.92%). Oleh karena itu, pasien kanker rawat inap yang mendapat elektrolit pekat cenderung mengalami MTO, sehingga penilaian resep dan pemantauan terapi obat perlu dilakukan secara cermat untuk mencapai target terapeutik dan meningkatkan keselamatan pasien."

"Latar belakang : Peresepan antibiotik (AB) yang tidak tepat umum terjadi di seluruh dunia dan berkontribusi pada meningkatnya organisme yang resisten. Diperlukan sistem surveilans untuk memantau penggunaan AB dan resistensi untuk pengambilan keputusan yang tepat.Indonesia belum pernah menerapkan Point prevalence survey (PPS) dalam evaluasi AB dan resistensi. Tujuan: untuk mengetahui profil penggunaan antibiotik dan resistensi mikroorganisme di rumah sakit menggunakan metode PPSMetode : penelitian potong lintang. Dilakukan pengumpulan data demografi, penggunaan antibiotik dan kultur resistensi mikroorganisme menggunakan formulir PPS.Hasil : Pada hari penelitian dilakukan survei terhadap 451 pasien, ditemukan 244 (54,1%) pasien mendapatkan AB dengan diagnosis paling banyak adalah pneumonia (25%). Alasan penggunaan antibiotik adalah untuk tatalaksana infeksi dari komunitas sebanyak 50,8%, infeksi dari fasilitas kesehatan sebanyak 15,5%, penggunaan AB sebagai profilaksis sebanyak 30,7% dan 3% tidak ditemukan alasan indikasi penggunaan AB. Diresepkan 368 AB, di manahanya 46 (12,5%) AB yang digunakan sebagai terapi definitif. Tiga AB yang paling sering digunakan adalah ceftriaxone (15,5%), levofloxacin 9,2% and ampicillin sulbactam 7,9%. Tanggal evaluasi penggunaan AB hanya tertulis pada 88 (22,3%) AB. Tidak tersedia pedomantatalaksana lokal sebanyak 83 (22,6%) penggunaan AB dan hanya 214 (58,2%) AB yang diresepkan sesuai dengan pedoman tata laksana lokal. Kami melakukan evaluasi terhadap 244 pasien yang menggunakan AB dan hanya 91 (38%) pasien yang dilakukan pemeriksaan kultur dan tes resistensi. Didapatkan 222 sampel, dimana 81 (36,5%) adalah steril. Tiga mikroorganisme terbanyak adalah Klebsiella pneumoniae 47 (20,7%), Pseudomonas aeruginosa 22 (9,9%) dan Escherichia coli 20 (9%). Jumlahmikroorganisme extended-spectrum β-lactamase (ESBL) didapatkan sebesar 21,4%, resisten terhadap karbapenem 12,5% dan Multiple drug resistance (MDR) sebesar 17,7%.Kesimpulan : lebih dari setengah pasien yang disurvei menggunakan AB dan angka kepatuhan penggunaan antibiotik masih belum baik, evaluasi resistensi kuman terbatas karena jumlah sampel yang diperiksa kurang. Pelaksanaan PPS terbukti efektif dan efisien.

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Background: Inappropriate antibiotic prescribing appears to be common worldwide and is contributing to the selection of resistant organisms. Surveillance systems to monitor antimicrobial use and resistance are needed to improve decision making and assess the effect of interventions. Point prevalence surveys (PPSs) in Indonesian hospitals have not yet been applied. Aim : to evaluate the antibiotic prescribing trends and microorganism resistance using PPS methods Methods: A one day, cross-sectional PPS was performed whereas total of 10 days were taken. Data on demographics, antimicrobial use and culture/resistance test of all adult inpatients were collected using a data collection form. Results: On the day of the study 451 adults patients were surveyed, 244 (54.1%) were received

368 antibiotics and the most common diagnosis was pneumonia (25%). Reasons of using the antibiotics were to treat community acquired infection (CAI) 50.8%, hospital acquired infection (HAI) 15.5%, prophylaxis 30.7% and 3% was unknown. 368 antibiotics prescriptions were issued, of which 46 (12.5%) were used for definitive therapy. The top three antibiotics prescribed were ceftriaxone (15.5%), levofloxacin 9.2% and ampicillin sulbactam 7.9%.

Review date of using antibiotics were performed in 88 (22.3%). Local guidelines was not available for 83 (22.6%) of prescribed antibiotics and among prescribed antibiotics with local guidelines available compliance was 214 (58.2%). We evaluate the culture test among those received antibiotics (244), 91 (38%) patients were

performed culture and resistance test. From these 222 samples of culture, 81 (36.5%) was sterile. The most three growth microorganisms were Klebsiella pneumoniae 47 (20.7%), Pseudomonas aeruginosa 22 (9.9%) and Escherichia coli 20 (9%). The number of extendedspectrum β-lactamase (ESBL) recorded at 21.4%, Carbapenem Resistanculture ce was 12.5% and Multiple drug resistance was 17.7%. Conclusions: more than half-of-patients surveyed by PPS in an hospital in Indonesia were on antibiotics, has a limitation due to availability of result and sample. Conducting PPS in teaching hospital proved to be effective and efficient. "

"Nama : NurchajatieProgram Studi : Ilmu Kesehatan MasyarakatJudul :Model Prediksi Perubahan Status Gizi Pasien Diabetes MelitusTipe 2 Di Ruang Rawat Inap RSUP Fatmawati Tahun 2018.Pembimbing : Ir. Ahmad Syafiq, M.Sc, Ph.dStatus gizi kurang akibat malnutrisi rumah sakit merupakan penurunan statusgizi karena kurangnya asupan atau daya terima makanan selama perawatan, danmenjadi masalah gizi pasien di rawat inap dan sering mendapat sorotan. Statusgizi kurang seringkali dijadikan prediksi lama rawat pasien di rumah sakit.Malnutrisi rumah sakit atau penurunan status gizi selain akibat dari kekuranganasupan makanan, peningkatan kebutuhan sehubungan dengan kondisipenyakitnya dan juga kepuasan terhadap pelayanan gizi, umur, jenis kelamin,selera makan, dan kepatuhan diet. Tujuan penelitian adalah mengetahui modelprediksi perubahan status gizi pasien diabetes melitus tipe 2. Penelitian iniadalah penelitian observasional analitik dengan pendekatan cross sectional.Hasil penelitian perubahan status gizi berdasarkan IMT rata-rata -0,2 0,3kg/m2. Dari hasil analisis regresi linier multivariate diperoleh model prediksiperubahan status gizi = - 0,764 0,004 Asupan Makan - 0,01 Kepatuhan diet ndash;0,014 Kepuasan terhadap pelayanan gizi 0,011 Selera makan. Kesimpulan:Apabila asupan makan , nilai skor kepatuhan diet, nilai skor kepuasan terhadappelayanan gizi serta nilai skor selera makan menurun, maka perubahan statusgizi akan semakin negatif menurun dan asupan makan merupakan variabelyang berpengaruh dalam perubahan status gizi pasien DM tipe 2.Kata kunci: perubahan status gizi, diabetes melitus , malnutrisi rumah sakit.

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ABSTRACTName NurchajatieStudy Program Public HealthTitle Prediction Model of the Change in Nutritional Status ofHospitalized Diabetes Melitus type 2 Patients inFatmawati General Hospital in 2018.Counsellor Ir. Ahmad Syafiq, M.Sc, Ph.dLack of nutrition caused by malnutrition during hospitalization is a decreasingnutritional status which is caused by lack of intake or the decreasing ability toaccept food intake during hospitalization and become a nutrition problem for apatient of which often becomes focus of attention. Patient 39 s lack of nutrition isoften used to predict the length of treatment in the hospital. Malnutrition ordecreasing nutrition status caused by lack of food intake, moreover caused byincreasing need related to the condition of the sickness and also the satisfactiontoward the services in nutrition provision, age, sex, appetite, and diet obedience.The main research objective is to know the model of prediction in the change ofnutritional status of diabetes mellitus type 2. This research is an analyticalobservational research using cross sectional approach. The research result in thechange of nutritional status is based on average IMT 0.2 0.3 kg m2. From theresult of multivariate linear regression, it is obtained the prediction model of thechange in nutritional status 0.764 0.004 Food intake 0.01 Diet obedience 0.014 Satisfaction towards services in nutrition provision 0.011 Appetite.Conclusion if the food intake, the score of satisfaction towards services innutrition provision, and the score of eating appetite are decreasing, then thechange in nutritional status tends to be more negative decreasing and the foodintake is an influential variable in the change of DM type 2 patient 39 s nutritionalstatus.Key words change in nutritional status, diabetes mellitus, hospital malnutrition"

"Latar belakang penelitian: Perawatan pasien dengan penyakit kritis, kompleks dan membutuhkan perawatan intensifcare unit (ICU), untuk mendapatkan perawatan yang baik dan meminimalkan kesalahan dalam tindakan medis. Perlu strategi untuk melihat perkembangan pasien setiap hari.Kemajuan untuk mendiagnosis, perawatan dan pengobatan penyakit yang berat atau dalam kondisi kritis meningkatkan. Kebutuhan ICU di rumah sakit berbagai negara seringkali melebihi fasilitas yang ada, khususnya perawatan yang ventilasi mekanis. Panduan, protokol atau standar dalam menseleksi pasien sangat dibutuhkan di ruang ICU dan harus memperhatikan etika kedokteran. Skor APACHE II dapat menilaioutcomepasien dari lepas ventilasi mekanis sampai kematian. Tujuan penelitian ini untuk melihat kelangsungan hidup serta faktor-faktor yang mempengaruhinya seperti karakteristik pada awal pemakaian ventilasi mekanis serta pengaturan sampai outcome pasien.Metode penelitian: Desain penelitian ini uji potong lintang dengan populasi pasien dewasa yang menggunakan ventilasi mekanis. Pengambilan sampel mengambil data di rekam medis dengan membuka status dan followupsheet. Data yang didapat dinilai karakteristik berdasarkan demografi, kasus dan indikasi perawatan IPI, risiko medis dan pemakaian ventilasi mekanis (VM) serta menilai outcome pasien di IPI. Hasil: Seratus enam puluh tujuh subjek dalam penelitian, terbanyak umur ≤ 44 tahun 70(41,9%), laki-laki101(60,5%), Jaminan sosial kesehatan 86 (51,5%), skor APACHE II untuk menilai mortalitas pasien dengan median 46,03(5,80-95,49). Kasus bukan bedah86(51,5%), kasuspenyakit paru hanya 68(40,7%) sedangkan gabungan kedua kasus terbanyak kasus bedah bukan penyakit paru 56(33,5%), pasca bedah indikasi pemasangan VM terbanyak 81(48,5%). Sepsis penyebab kematian terbanyak 66(62,9%).Outcome pasienlepas VM 68(40,7%), tindakan trakeostomi8(3,8%), keluar IPI dalam kondisi hidup 61 orang (36,5%). Kesimpulan: Karakteristik dari pasien sangat mempengaruhi outcome pasien seperti umur, diagnosis dan jaminan kesehatan dan pentingnya suatu penilaian seperti skor APACHE II untuk melihat mortalitas.

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Background research: Treatment of patients with critical illness, complex and require intensive care ( ICU ), to get good care and minimize errors in medical treatment. Strategies need to see the patient's progress every day. Progress to diagnose, care and treatment of severe disease or in critical condition improves. Needs of the hospital ICU in various countries often exceed existing facilities, particularly mechanical ventilation treatment. Guidelines, protocols or standards for the selection of patients is needed in the ICU and had to pay attention to medical ethics. APACHE II scores to assess the outcomes of patients off mechanical ventilation until death. The purpose of this study to look at the viability and the factors that influence such characteristics at the beginning of the use of mechanical ventilation as well as setting up patient outcomes.

Methods: Design A cross-sectional study with a test population of adult patients using mechanical ventilation. Sampling took the data in the medical record by opening the status and folllow sheet. Data obtained assessed based on demographic characteristics, cases and indications IPI care, medical risks and the use of the VM as well as assess the outcomes of patients in the IPI.

Results: One hundred sixty- seven subjects in the study, most aged ≤ 44 years 70 ( 41.9 % ), 101 men ( 60.5 % ), Social Security Health 86 ( 51.5 % ), APACHE II score to assess the mortality of patients with a median of 46.03( 5.80 to 95.49 ). Instead of 86 surgical cases ( 51.5 % ), only 68 cases of lung disease ( 40.7 % ) while the second combined surgical cases instead of cases of lung disease 56 ( 33.5 % ), post- surgical indications VM pemasanan most 81 ( 48, 5 % ). Sepsis causes the most deaths 66 ( 62.9 % ). Outcome off VM 68 patients ( 40.7 % ), tracheostomy measures 8 ( 3.8 % ), out of IPI in living conditions 61 ( 36.5 % ).

Conclusion: Characteristics of patients greatly affects patient outcomes such as age, diagnosis and health insurance and the importance of an assessment such as APACHE II score to see mortality."

"ABSTRAKLatar belakang: Perawatan-kembali 30 hari merupakan salah satu parameter penting yang berhubungan dengan biaya kesehatan tinggi dan outcome yang buruk, namun hal ini berpotensi dicegah. Usia lanjut merupakan kelompok yang rentan mengalami perawatan dengan karakteristik khusus yang dapat dinilai dengan pengkajian paripurna pasien geriatri (P3G). Beberapa penelitian menunjukkan komponen P3G merupakan faktor prognostik perawatan-kembali pada pasien usia lanjut sehingga dapat digunakan sebagai model prediksi perawatan-kembali 30 hari pada populasi ini. Belum ada penelitian prospektif yang khusus menilai komponen P3G sebagai model prediksi perawatan-kembali 30 hari. Tujuan: Mengembangkan model prediksi perawatan-kembali 30 hari pada pasien usia lanjut yang dirawat di bangsal medik RS Cipto Mangunkusumo. Metode: Penelitian adalah studi kohort prospektif pada 263 subjek usia >60 tahun yang diikuti hingga 30 hari pasca rawat. Data demografis dan komponen P3G dikumpulkan melalui wawancara dan rekam medik saat perawatan. Analisis kesintasan secara bivariat dan multivariat berjenjang dilakukan untuk mendapatkan hazard ratio. Dikembangkan suatu model prediksi dan persamaan fungsi hazard untuk memprediksi risiko perawatan-kembali 30 hari pasca rawat. Komponen P3G yang diukur adalah skor FRAIL (fatigue, resistance, ambulance, illness, loss of weight), Geriatric Depression Scale-15 (GDS-15), Mini nutrition Assessment short form (MNA-SF), Activity Daily Living (ADL)-Barthelindex, Cumulative illness rating scale-geriatric (CIRS-G), Zarits-4 item screening test, uji Mini Cog, dan polifarmasi. Hasil: Status nutrisi dan status depresi berhubungan secara signifikan dengan perawatan-kembali 30 hari dengan HR 2,368 (IK95%: 1,412-3,972, p=0,001) dan HR 1,627 (IK95%: 1,080-2,450, p=0,02), berurutan. Model prediksi menggunakan dua komponen tersebut memiliki AUC 0,663, Hosmer Lemeshow Goodness-of fit test 0,48, p<0,005. Probabilitas perawatan kembali 30 hari pada subjek dengan gangguan nutrisi dan depresi menggunakan persamaan fungsi Hazard adalah 79%. Simpulan: Status nutrisi dan status depresi memiliki hubungan signifikan dengan perawatan-kembali 30 hari. Model prediksi perawatan-kembali 30 hari yang menggunakan komponen ini memiliki tingkat diskriminasi tidak terlalu baik dengan performa yang baik, namun dapat dihitung menggunakan suatu persamaan cox proportional Hazard.

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ABSTRACTassociated with high costs and poor outcomes for hospitalized elderly patients. This population are vulnerable for hospital admission due to aging-related characteristics which can be assessed by comprehensive geriatrics assessment (CGA). Several studies have shown that CGA components were related to 30-day readmissions in elderly patients, on the contrary, only few studies consider these components as predictive score. Objective: To develop a prediction model for 30 days unplanned readmission in elderly patients who are treated in medical ward of Cipto Mangunkusumo Hospital. Methods: A prospective observational study followed 312 subjects aged >60 years old from admission to 30 days after discharge. Demographic data and CGA components were compeleted through interviews and medical records. Bivariate followed by stepwise multivariate survival analysis was used. Then, a prediction score and a hazard functional equation were developed to predict the risk of 30 days unplanned readmission. The CGA components measured were FRAIL score (fatigue, resistance, ambulance, illness, loss of weight), Geriatric Depression Scale-15 (GDS-15), Mini nutrition Assessment short form (MNA-SF), Activity Daily Living (ADL)-Barthel index, Cumulative illness rating scale-geriatric (CIRS-G), Zarits-4 item screening test, Mini Cog test, and polypharmacy. Results: Nutritional and depression status were significantly related to 30-day unplanned readmission with HR 2,368 (CI95%: 1,412-3,972, p=0,001) and HR 1,627 (CI95%: 1,080-2,450, p=0,02), respectively. Prediction model using these two components had AUC 0,663, Hosmer Lemeshow Goodness-of-fit test 0,48, p<0.005. Probability for readmission in a patient with nutritional and depression problem on the 30th days after discharge using functional hazard equation was 79%.Conclusion: Nutritional and depression status have significant relationship with 30-day unplanned readmision. The prediction model had moderate level of discrimination but good calibration. Also, a cox proportional hazard equation can be calculated as an alternative. "

"Penyakit kardiovaskuler merupakan penyebab kematian utama penduduk dunia (30%). Untuk menghadapi masalah ini perlu diketahui distribusi penyakit kardiovaskuler terhadap faktor-faktor risikonya secara lebih spesifik. Penelitian ini bertujuan untuk mengetahui gambaran penyakit kardiovaskuler pada pasien rawat inap di Rumah Sakit Jantung dan Pembuluh Darah (RSJPD) Harapan Kita Tahun 2012. Penelitian ini menggunakan data sekunder dari rekam medik RSJPD Harapan Kita menggunakan desain studi cross sectional dengan jumlah sampel 339 orang dianalisis secara univariat. Hasil menunjukkan Ischemic Heart Diseases merupakan penyakit dengan proporsi terbesar yaitu 43,36%. Berdasarkan letak lesi, penyakit jantung memiliki proporsi terbesar yaitu 87,02%. Penyakit kardiovaskuler cenderung mengenai kelompok usia 51-60 tahun dengan proporsi 29,79%. Penyakit kardiovaskuler cenderung menyerang laki-laki dan orang dengan tingkat pendidikan menengah. Diketahui bahwa proporsi pasien hipertensi dan diabetes mellitus cenderung lebih besar di antara pasien penyakit pembuluh darah otak daripada pada pasien penyakit jantung ataupun pasien penyakit pembuluh darah perifer.

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Cardiovascular disease is the most common death cause (30%) . To face the problem it’s necessary to know the distribution of cardiovascular disease specifically to its risk factors. This research aims to describe the cardiovascular disease among the hospitalized patients in Harapan Kita Cardiovascular Hospital in 2012. This research uses the secondary data from Harapan Kita Cardiovascular Disease medical record and also uses cross sectional design with 339 sample and analyzed in univariate.

The results show that among the cardiovascular diseases in inpatient unit in Harapan Kita Cardiovascular Hospital, Ischemic Heart Diseases is the diseases with the biggest proportion which is 43,36%. According to lesion location, heart disease has the biggest proportion which is 87,02%. Cardiovascular diseases tend to affect the 51-60 years old group of age by 29,79% among other age groups. Cardiovascular diseases tend to affect men and those who have middle educational level. The results also show that proportion of patients with hypertension and Diabetes Melitus tends to be bigger among cererovascular diseases patients than heart diseases patients or peripheral vascular diseases patients."

"[ABSTRAKLatar Belakang. Perburukan fungsi ginjal berkaitan dengan luaran klinis yang lebih buruk pada pasien gagal jantung dekompensasi akut. Karakteristik klinis pada saat pasien masuk ke unit gawat darurat (UGD) dapat menolong untuk identifikasi pasien yang berisiko terhadap kejadian perburukan fungsi ginjal. Tujuan penelitian ini adalah membuat sistem skor untuk mempermudah identifikasi pasien yang berisiko terhadap perburukan fungsi ginjal pada gagal jantung dekompensasi akut.Metode. Studi kohort retrospektif dilakukan terhadap 614 pasien yang menjalani perawatan karenan gagal jantung dekompensasi akut. Perburukan fungsi ginjal didefinisikan sebagai peningkatan nilai kreatinin serum ≥ 0.3 mg/dL kapanpun selama perawatan atau ≥ 25% dari awal masuk perawatan.Hasil. Perburukan fungsi ginjal terjadi pada hampir 26% pasien. Prediktor independen terhadap kejadian perburukan fungsi ginjal yang didapat melalui analisis dengan logistik regresi backward selection adalah usia > 75 tahun (p < 0.0001); perempuan (p = 0.034); riwayat hipertensi (p = 0.001); anemia (p = 0.005); dan serum Creatinin saat masuk di UGD > 2.5 mg/dL (p = 0.013). Sistem skor dibuat dari model akhir tersebut. Dilakukan validasi internal dengan metode bootstrap didapatkan hasil optimisme yang baik (0.01088808).Kesimpulan. Sistem skor baru dapat memprediksi kejadian perburukan fungsi ginjal pada pasien gagal jantung dekompensasi akut yang menjalani rawat inap.

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ABSTRACTBackground. Worsening renal function (WRF) is associated with worse outcomes among patients who are hospitalized with acute decompensated heart failure (ADHF). Clinical characteristics at admission may help identify patients at increased risk of WRF. The aim of this study was to create in admission scoring system to simplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed. By the definition WRF occurred when serum Creatinin increased at anytime during hospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. The independent predictors of WRF analyzed with backward selection logistic regression were: age > 75 years old (p < 0.0001), female (p = 0.034); history of hypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p = 0.013). A scoring system was generated from this final model. An internal validation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure., Background. Worsening renal function (WRF) is associated with worse outcomesamong patients who are hospitalized with acute decompensated heart failure(ADHF). Clinical characteristics at admission may help identify patients at incresedrisk of WRF. The aim of this study was to create in admission scoring system tosimplify identification patients at risk of WRF in ADHF setting.Methods. A retrospective data of 614 patients admitted with ADHF was analyzed.By the definition WRF occurred when serum Creatinin increased at anytime duringhospitalization by ≥ 0.3 mg/dL or by ≥ 25% from admission.Results. Worsening renal function developed in near 26% patients. Theindependent predictors of WRF analyzed with backward selection logisticregression were: age > 75 years old (p < 0.0001), female (p = 0.034); history ofhypertension (p = 0.001); anemia (p = 0.005); and in admission serum Creatinin (p= 0.013). A scoring system was generated from this final model. An internalvalidation with bootstrap method showed good optimism (0.01088808).Conclusion. A new scoring system could predict in-hospital worsening renal function among patients hospitalized with acute decompensated heart failure.]"