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"Latar belakang: Penelitian ini bertujuan untuk menunjukkan perbedaan rerata nilai rasio Kolagen I (Kol I)/Nitric Oxide(NO), Kolagen IV (Kol IV)/NO, Tissue Factor (TF)/NO, P-selectin (P-sel)/NO antara pasien dengan trombosis vena dalam (TVD) positif dan TVD negatif, pasca traumatisasi spongiosa meta-epifisis sendi panggul dan lutut pada operasi besar ortopedi.Metode: Studi observasional kohort prospektif kasus operasi ortopedi tanpa tromboprofilaksis pada 69 pasien berumur > 50 tahun. Pemeriksaan kadar serum biomarker Kol I, Kol IV, TF, P-sel, dan NO dilakukan tiga kali yaitu sebelum operasi, 72 jam sesudah operasi, dan 144 jam sesudah operasi, masing-masing untuk melihat perbedaan rerata kadar biomarker dan rerata nilai rasio protrombogenik/ antitrombogenik (Kol I/NO, Kol IV/NO, TF/NO dan P-sel/NO) pada 72 jam dan 144 jam sesudah operasi antara pasien TVD positif dan TVD negatif. Kejadian TVD dikonfirmasi pada 144 jam sesudah operasi dengan venografi (kecuali pada 8 kasus yang dikonfirmasi dengan USG color Doppler karena kontra indikasi zat warna).Hasil: Kejadian TVD positif didapatkan pada 18 pasien (26,1%). Perbedaan rerata kadar antara TVD positif dan TVD negatif ditemukan pada Kol IV sebelum operasi (p = 0,022) dan pada NO 72 jam sesudah operasi (p = 0,014). Perbedaan rerata nilai rasio protrombogenik/ antitrombogenik antara TVD positif dan TVD negatif ditemukan pada rasio Kol IV/NO, TF/NO, dan P-sel/NO pada 72 jam sesudah operasi (p = 0,007; p = 0,028; p = 0,049), dengan median yang lebih rendah pada pasien dengan TVD positif. Sedangkan pada 144 jam sesudah operasi, perbedaan rerata nilai rasio hanya ditemukan pada rasio Kol IV/NO (p = 0,014) dengan nilai median yang lebih tinggi dari median pada 72 jam sesudah operasi.Kesimpulan: Kejadian TVD pada traumatisasi spongiosa meta-epifisis pasca operasi besar ortopedi sendi panggul dan lutut dipengaruhi oleh keseimbangan protrombogenik dan antitrombogenik yang ditunjukkan dengan adanya perbedaan rasio Kol IV/NO, TF/NO dan Psel/NO pada 72 jam dan rasio Kol IV/NO pada 144 jam sesudah operasi antara TVD positif dan TVD negatif.

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AbstractBackground: This study was aimed to show differences in the mean values of Collagen I (Col I)/Nitric Oxide (NO), Collagen IV (Col IV)/NO, Tissue Factor (TF)/NO, and P-selectin (P-sel)/NO ratios between patients with DVT and those without DVT, following hip and knee meta-epiphyseal cancellous bone traumatization in major orthopedic surgeries.Methods: This is an observational prospective cohort study on 69 patients aged > 50 years, who had orthopedic surgery without thromboprophylaxis. Examination of serum Col I, Col IV, TF, P-sel, and NO biomarker levels were performed three times, i.e. before surgery, 72 hours and 144 hours after surgery. We looked for the differences in mean levels of biomarkers, and mean ratio values of the prothrombogenic/ antithrombogenic (Col I/NO, Col IV/NO, TF/NO, P-sel/NO) at 72 hours and 144 hours post surgery between patients with DVT and those without. DVT events, which were confirmed at 144 hours post surgery by venography (with the exception of 8 cases where color Doppler ultrasound was done due to contrast usage contraindications).Results: DVTs were identified in 18 patients (26.1%). There were significant differences of mean levels in pre-surgical Col IV (p = 0.022) and 72 hours NO (p = 0.014) between patients with and without DVT. In addition, between the same two patient groups, significant differences were found in the mean values of the prothrombogenic/antithrombogenic ratios, i.e. Col IV/NO, TF/NO, and P-sel/NO at 72 hours post-surgery (p = 0.007, p = 0.028, and p = 0.049 respectively), with lower median values that were found in subjects with DVT. At 144-hours post surgery, the only significant ratio difference between the two groups was the mean values of Col IV/NO ratio (p = 0.014) with the median values that were higher than the median values at 72-hours post surgery .Conclusion: The incidence of DVT following traumatization of the meta-epiphyseal cancellous bone after major orthopedic surgeries in hip and knee is influenced by the balance of prothrombogenic and antithrombogenic factors as shown by the significant differences in Col IV/NO, TF/NO and P-sel/NO ratios at 72-hours and Col IV/NO ratio at 144 hours after surgery between DVT positive and DVT negative patients."

"Latar Belakang: Deep Vein Thrombosis (DVT) merupakan salah satu masalah dengan angka mortalitas jangka pendek dan morbiditas jangka panjang. Sebanyak 60% kasus DVT tidak memiliki gejala. Seiring bertambahnya usia, insiden DVT akan terus meningkat. Sekitar 1 dari 100.000 orang tiap tahunnya akan menderita DVT dibawah usia 50 tahun dan meningkat menjadi 1000 dari 100.000 per tahun di usia 85 tahun. Pada satu pertiga kasus bermanifestasi sebagai emboli paru, sedangkan dua pertiga lainnya hanya sebatas DVT. Terdapat kenaikan kadar fibrinogen maupun d-dimer pada pasien dengan keganasan.Penelitian ini bertujuan menganalisa dan membandingkan kadar fibrinogen, d-dimer dan dosis heparin terapeutik pada pasien DVT dengan keganasan dan non keganasan. Metode: Penelitian ini merupakan kohort retrospektif menggunakan rekam medis di RS Cipto Mangunkusumo. Variabel bebas adalah terapi pada pasien DVT sedangan variabel terikatnya adalah kadar D-dimer, fibrinogen dan aPTT terapeutik. Analisa statistic menggunakan SPSS versi 20, nilai p<0.05 menunjukkan terdapat hubungan bermakna secara statistik. Hasil: 63 pasien masuk dalam penelitian, didapatkan pasien DVT dengan keganasan sebanyak 33 pasien (52,4%) dan pasien DVT non keganasan sebanyak 30 pasien (47,6%). Kadar fibrinogen, D-dimer awal dan akhir pada pasien DVT dengan keganasan memiliki kadar yang lebih tinggi secara bermakna dibandingkan dengan DVT non keganasan (p<0,001). Terdapat perbedaan signifikan pada penurunan D-dimer pasien DVT dengan keganasan dibandingakan dengan pasien DVT non kegananasan. Dosis heparin awal pasien DVT dengan keganasan memiliki nilai tidak bermakna dibandingkan dengan DVT non keganasan (p>0,001). Dosis heparin terapeutik pada pasien DVT dengan keganasan bermakna signifikan lebih tinggi dibandingkan DVT non keganasan (p<0,001). Simpulan: Terdapat perbedaan yang bermakna pada kadar fibrinogen, d-dimer awal dan akhir yang bermakna antara pasien DVT keganasan dengan pasien DVT non keganasan. Terdapat perbedaan yang bermakna pada penurunan D-dimer pasien DVT dengan keganasan dan DVT non keganasan. Ditemukan perbedaan bermakna pada dosis heparin terapeutik pasien DVT dengan keganasan dan DVT non keganasan.

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Background: Deep Vein Thrombosis (DVT) is a problem with short-term mortality and long-term morbidity. As many as 60% of DVT cases have no symptoms. With age, the incidence of DVT will continue to increase. About 1 in 100,000 people each year will suffer from DVT under the age of 50 years and this increases to 1000 from 100,000 per year at the age of 85 years. In one third of cases it manifests as a pulmonary embolism, while in the other two thirds only a DVT is present. There is an increase in the levels of fibrinogen and d-dimer in patients with malignancy. This study aims to analyze and compare the levels of fibrinogen, d-dimer and therapeutic doses of heparin in malignant and non-malignant DVT patients.

Method: This study is a retrospective cohort using medical records at Cipto Mangunkusumo Hospital. The independent variable is therapy in DVT patients while the dependent variable is the level of D-dimer, fibrinogen and therapeutic aPTT. Statistical analysis using SPSS version 20, p value <0.05 indicates that there is a statistically significant relationship.

Results: 63 patients were included in the study, 33 patients with malignant DVT were found (52.4%) and 30 patients with non-malignant DVT (47.6%). The initial levels of fibrinogen in patient with malignant DVT were significantly higher than those of non malignant DVT (p<0.05). The final levels of fibrinogen in patient with malignant DVT were significant higher than those of non malignant DVT (p<0,05).There was significant higher of D-dimer initial levels beetween patient with malignant DVT and patient with non malignant DVT (p<0,05). There was significant higher of D-dimer final levels beetween patient with malignant DVT and patient with non malignant DVT (p<0,05). There was a significant difference in the decrease of d-dimer levels between DVT patients with malignancy compared to non-malignant DVT patients who were given heparin therapy. The initial heparin dose in patients with malignant DVT had no significant value compared to non malignant DVT (p>0.001). The therapeutic dose of heparin in patients with malignant DVT was significantly higher than that of non malignant DVT (p<0.001).

Conclusion: There was a significant difference in the levels of fibrinogen and D- dimer initial and final which was significant between malignant DVT patients and non-malignant DVT patients. There is a significant difference in the decrease in D-dimer in patients with malignant DVT and non-malignant DVT. A significant difference was found in the therapeutic dose of heparin in patients with malignant DVT and non-malignant DVT."

"Pendahuluan: Deep Vein Thrombosis (DVT) memiliki kecenderungan terus meningkat dengan koinsidensi mortalitas jangka pendek dan morbiditas jangka panjang. COVID-19 dapat menyebabkan hypercoagulable state dan menjadi predisposisi terjadinya DVT. Penelitian ini bertujuan untuk menganalisis hubungan kadar fibrinogen, D-Dimer, dan dosis heparin teraupetik berdasarkan kadar APTT dengan adanya COVID-19 pada pasien DVT. Metode: Desain penelitian komparatif dan kohort prospektif digunakan untuk membandingkan kadar fibrinogen, D-Dimer, dan dosis heparin terapeutik antara pasien COVID-19 dan non COVID-19 yang menderita DVT di RSPN Cipto Mangunkusumo pada bulan Maret 2020 – Maret 2022. Penegakan diagnosis DVT dilakukan dengan pemeriksaan ultrasonografi dan/atau computed tomography angiography (CTA) fase vena. Data variabel utama dan lainnya diperoleh dari rekam medis pasien. Uji T independen atau Mann-Whitney digunakan untuk menganalisis perbedaan nilai variabel antara kedua kelompok. Hasil: Dari total 253 sampel, tidak terdapat perbedaan karakterisitik awal antara kelompok DVT COVID-19 (n=44) dan DVT non COVID-19 (n=209), kecuali pada parameter Wells Score. Kelompok DVT COVID-19 memiliki kadar Fibrinogen, D-Dimer, dan aPTT yang lebih tinggi daripada kelompok DVT non COVID-19, baik sebelum terapi maupun sesudah terapi heparanisasi (semua nilai p =0,000). Pada akhir pengamatan, didapatkan dosis heparin terapeutik pada kelompok DVT COVID-19 lebih tinggi dibanding pada kelompok DVT non COVID-19 (30,00 (20,00-40,00)x103 U vs. 25,00 (20,00-35,00)x103 U, p=0,000). Kesimpulan: Kadar fibriongen, D-Dimer, dan dosis heparin terapeutik pada pasien DVT yang menderita COVID-19 lebih tinggi dibandingkan pada pasien DVT yang tidak menderita COVID-19. Inisiasi pemberian dosis heparin terapeutik dosis tinggi dapat dipertimbangkan pada pasien DVT dengan komorbid COVID-19 dan dipandu oleh hasil pemeriksaan biomarker koagulasi darah.

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Introduction: Deep Vein Thrombosis (DVT) has an increasing trend with a coincidence of short-term mortality and long-term morbidity. COVID-19 can cause a hypercoagulable state and predispose to DVT. This study aims to analyze the relationship between fibrinogen levels, D-Dimer, and therapeutic heparin doses based on APTT levels in the presence of COVID-19 in DVT patients. Methods: A comparative study design and a prospective cohort were used to compare levels of fibrinogen, D-Dimer, and therapeutic heparin doses between COVID-19 and non-COVID-19 patients suffering from DVT at Cipto Mangunkusumo Hospital in March 2020 – March 2022. Diagnosis of DVT was performed by ultrasound examination and/or computed tomography angiography (CTA) venous phase. The primary variable data and others were obtained from the patient's medical record. An Independent T-test or Mann-Whitney was used to analyze the differences in variable values between the two groups. Results: Of 253 samples, there was no difference in initial characteristics between the DVT COVID-19 (n=44) and non-COVID-19 DVT groups (n=209), except for the Wells Score parameter. The COVID-19 DVT group had higher levels of fibrinogen, D-Dimer, and aPTT than the non-COVID-19 DVT group, both before and after heparinization therapy (all p-values = 0.000). At the end of the follow-up period, the therapeutic dose of heparin in the COVID-19 DVT group was higher than in the non-COVID-19 DVT group (30.00 (20.00-40.00)x103 U vs. 25.00 (20.00-35.00)x103 U, p-value=0.000). Conclusion: The levels of fibrinogen, D-Dimer, and therapeutic doses of heparin in DVT patients who have COVID-19 are higher than in DVT patients who do not have COVID-19. Initiation of a higher therapeutic dose of heparin can be considered in DVT patients with comorbid COVID-19 and guided by the results of blood coagulation biomarkers."

"Latar Belakang: Deep Vein Thrombosis (DVT) adalah salah satu penyakit penyebab mortalitas jangka pendek dan morbiditas jangka panjang. Kasus DVT akan meningkat seiring bertambahnya usia. Pada pasien dengan keganasan, risiko DVT meningkat hingga 4,1 kali lipat karena kondisi hiperkoagulasi. Penatalaksanaan DVT antara lain pemberian antikoagulan dan kompresi eksterna. Penelitian ini bertujuan membandingkan luaran antropometrik tungkai pasien DVT dengan keganasan dan non-keganasan yang diterapi heparin.Metode: Kohort retrospektif menggunakan rekam medis di RS Cipto Mangunkusumo. Variabel bebas adalah status keganasan pada pasien DVT sedangkan variabel terikatnya adalah pengukuran antropometrik lingkar tungkai sebelum terapi heparin, 4 hari, dan 7 hari. Analisis statistik menggunakan SPSS versi 25, nilai p<0,05 menunjukkan kemaknaan secara statistik.Hasil: Sebanyak 63 subjek penelitian, didapatkan subjek DVT dengan keganasan sebanyak 33 subjek (52,4%) dan DVT non keganasan sebanyak 30 subjek (47,6%). Pada awal terapi, tidak terdapat perbedaan ukuran antropometrik antara DVT keganasan dan non keganasan. Pada hari ke-4 dan ke-7 terapi, terdapat perbedaan perbaikan ukuran antropometrik di mid femur, distal femur, dan mid cruris, dimana perbaikan klinis lebih tampak pada DVT non keganasan (p<0,05). Subjek DVT keganasan memiliki dosis heparin maintenance teraputik yang lebih tinggi (p=0,000), dan mencapai waktu kadar APTT terapeutik yang lebih lama (p=0,000).Kesimpulan: Subjek DVT keganasan menunjukkan perbaikan klinis yang lebih kecil dibandingkan DVT non keganasan. Selain itu, memerlukan dosis heparin maintenance terapeutik yang lebih tinggi, dan mencapai waktu kadar APTT terapeutik yang lebih lama.

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Background: Deep Vein Thrombosis (DVT) is a disease that causes short-term mortality and long-term morbidity. DVT cases will increase with age. In patients with malignancy, the risk of DVT increases up to 4.1-fold due to the hypercoagulable state. Treatment for DVT includes anticoagulants and external compression. This study aims to compare the anthropometric outcomes of the limbs of DVT patients with malignancy and non-malignancy treated with heparin.

Method: Retrospective cohort study using medical records at Cipto Mangunkusumo Hospital. The independent variable is malignancy status in DVT patients while the dependent variable is anthropometric measurements of leg circumference at first day, 4 days and 7 days heparin therapy. Statistical analysis using SPSS version 25, p<0.05 showed statistical significance.

Results: Of the 63 study subjects, 33 subjects (52.4%) had DVT with malignancy and 30 subjects (47.6%) had non-malignant DVT. At the start of therapy, there was no difference in anthropometric measures between malignant and non-malignant DVT. On the fourth and seventh days of therapy, there were differences in anthropometric size improvement in the mid femur, distal femur, and mid cruris, whereas clinical improvement was more evident in nonmalignant DVT (p<0.05). Malignant DVT subjects had higher therapeutic maintenance heparin doses (p=0.000), and achieved longer therapeutic APTT levels (p=0.000).

Conclusion: Malignant DVT subjects showed less clinical improvement than non-malignant DVT. In addition, it requires higher therapeutic maintenance heparin doses, and achieves a longer therapeutic APTT level time."

"Tujuan; membandingkan pemeriksaan trombosis vena dalam atau deep vein thrombosis (DVT) pada tungkai antara venografi 99m Tc Red Blood Cell (RBC) dengan venografi konvensional. Bahan dan Metoda: Empat belas orang diperiksa dengan venografi 99m Tc RBC dan venografi konvensional pada tungkai dengan kecurigaan DVT. Hasil : hasil pemeriksaan venografi 99m Tc RBC didapatkan 7 tungkai (38,6%) positif DVT dan yang negatif sebanyak 12 tungkai (61,4%), sedangkan hasil pemeriksaan venografi konvensional didapat 15 tungkai (78,9%) positif dan 4 tungkai (21,1 %) negatif. Dari hasil penelitian ini didapatkan bahwa venografi 99m Tc RBC mampu meningkatkan kepekaan venografi konvensional sebesar 53,3%. Kesimpulan : Venografi 99m Tc-RBC mempunyai kepekaan lebih tinggi dibandingkan venografi konvensional mendiagnosa DVT tungkai.

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Purpose: To compare diagnosis deep vein thrombosis (DVT) of lower extremities between convemional venography with 99"'Tc RBC venography. Materials and methods : Fourteen patients with suspected DVT of their lower extremities underwent 99mTc-RBC venography followed by conventional venography. Results : There are 7 legs (38,6%) positive DVT and 12 legs (61,4%) negative by 99"'Tc RBC venography and there are 15 legs (78,9%) positive DVT and 4 legs (21,1%) negative by conventional venography. From experimental analytic found 9 9t"Tc-RBC venography could be increased 53,3% sensivity of conventional venography. Conclusion: Comparing conventional venography, 99"'Tc-RBC venography has more sensitiv to make diagnosis DVT of lower extremity."

"Kasus trombosis vena dalam (TVD) pasca operasi di Indonesia dianggap jarang, demikian pula dengan trombofilia. Oleh karena itu, penulis berpendapat bahwa diperlukan penelitian untuk mendapat angka kejadian TVD pasca operasi ortopedi risiko tinggi, dan profil trombofilia pada kasus TVD dan non-TVD di Indonesia. Penelitian cross sectional ini dilakukan pada 20 pasien yang menjalani operasi daerah panggul (total hip replacement dan fiksasi fraktur femur proksimal) dan daerah lutut (fiksasi femur distal dan total knee replacement). Pada tiap pasien dilakukan pemeriksaan protein C, protein S, antitrombin III, dan fibrinogen pada hari kelima pasca operasi, kemudian pada periode antara hari kesepuluh dan keduapuluhsatu pasca operasi dilakukan pemeriksaan USG kompresi/Doppler vena. Bila hasil USG-nya menunjukkan adanya TVD, maka dikonfirmasi dengan venografi. TVD ditemukan pada lima pasien (25%). Defisiensi protein C (P= 0,46), protein S (P= 0,81), antitrombin III (P= 0,46), dan hiperfibrinogenemia (P= 0,0547) tidak berkorelasi dengan TVD pasca operasi. Namun demikian, hiperfibrinogenemia merupakan faktor risiko TVD pasca operasi (attributable risk= 1). Faktor penyerta lain seperti diabetes mellitus (P= 1,0), obesitas (P= 0,28), hipertensi (P= 1,0), hipertrigliseridemia, dan hiperkolesterolemia tidak berkorelasi dengan TVD pasca operasi. Penelitian ini menunjukkan adanya kasus TVD pasca operasi di Indonesia. TVD tidak berkorelasi dengan defisiensi protein S, protein C, dan antitrombin III. (Med J Indones 2004; 13: 24-30).

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Post operative DVT is believed to be rare in Indonesia, and so is trombophilia. It is necessary to know the incidence of postoperative DVT in Indonesia and thrombophlia profile (protein C, S, AT III deficiency and hyperfibrinogenemia) in DVT and non DVT patient who underwent orthopedic surgery involving the hip and knee (high risk surgery). A cross sectional study was conducted in 20 patients who underwent surgery involving the hip (total hip replacement and fixation of proximal femoral fracture) and knee (total knee replacement and fixation of distal femoral fracture). Protein C, protein S, antithrombin III, and fibrinogen were examined in day 5 post operative, as well as with compression/Doppler USG between day 10 to 21 post operative, and confirmed by venography if USG findings was positive. Post operative DVT were found in 5 of 20 patients (25%). Deficiency of protein C (P= 0.46) protein S (P= 0.81), antithrombin III (P= 0.46), and hyperfibrinogenemia (P= 0.0547) did not correlate to post operative DVT. However, hyperfibrinogenemia was found to be a risk factor to post operative DVT (attributable risk= 1). Other confounding factor such as diabetes mellitus (P= 1.0), obesity (P= 0.28), hypertention (P= 1.0), hypertrigliseridemia, and hypercholesterolemia did not correlate to post operative DVT. The study suggested the existence of postoperative DVT cases in Indonesia. Hyperfibrinogenemia is a risk factor to promote post operative DVT. Deep vein thrombosis did not correlate to protein S, protein C, and antithrombin III deficiency. (Med J Indones 2004; 13: 24-30)."

"Sindrom Pasca Trombosis SPT menyebabkan ketidakonsistenan efektivitas terapi pada pasien Trombosis Vena Dalam TVD karena faktor faktor yang memengaruhi timbulnya SPT belum sepenuhnya dipahami Penelitian ini bertujuan mengetahui faktor faktor yang memengaruhi kejadian SPT pada pasien TVD Penelitian cross sectional ini dilakukan pada 91 sampel Dengan uji chi square didapatkan bahwa faktor faktor yang berhubungan bermakna dengan kejadian SPT adalah jenis kelamin p 0 01 kadar D Dimer p 0 01 riwayat hipertensi p.

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Post Thrombotic Syndrome PTS results in inconsistency of Deep Vein Thrombosis DVT because the factors influencing PTS incidence is not fully understand yet This study aims to understand factors influencing PTS incidence in DVT patients This cross sectional study was being done in 91 samples With chi square test it can be concluded that there is a significant relationship between PTS incidence and gender p 0 01 D Dimer level p 0 01 hypertension p."

"LATAR BELAKANG: Keganasan meningkatkan risiko trombosis vena sekitar 2-7 kali. Insideni trombosis vena pada tumor ganas ovarium dilaporkan berkisar antara 5-29 . Berbagai faktor yang terkait dengan kondisi pasien usia, indeks massa tubuh, komorbid , karakteristik tumor ukuran, stadium, histologi, ascites dan terapi kemoterapi, lama pembedahan, jumlah perdarahan di laporkan dapat menjadi prediktor trombosis vena dalam TVD namun penelitian mengenai model prediksi TVD khususnya untuk populasi Indoensia masih terbatas. TUJUAN: Mengetahui faktor ndash; faktor prediktor trombosis vena dalam pada tumor ganas ovarium. DESAIN DAN METODE: Penelitian cohort prospektif ini dilakukan di RSUPN Cipto Mangunkusumo, Jakarta dan merekrut 116 pasien dengan dugaan tumor ganas ovarium yang akan menjalani operasi. Berbagai variable lain yang diduga sebagai prediktor TVD seperti kadar pra-terapi trombosit, D-Dimer, fibrinogen, usia, indeks massa tubuh IMT , komorbid, stadium, diameter, histologi, bilateralitas tumor, adanya ascites, metastasis jauh diukur dan dicatat. Pasien diikuti untuk gejala dan tanda TVD. Pasien yang memiliki gejala dan tanda klinis TVD dilakukan pemeriksaan Ultrasonografi Duplex vascular. HASIL: Seratus tiga pasien tumor ganas ovarium diikutkan dalam analisis. Insideni TVD adalah 16.5 dan 88.2 kejadian TVD terjadi sebelum pembedahan. Tidak ditemukan kejadian TVD selama perawatan pasca operasi dengan rata rata lama perawatan 8.8 hari. Kombinasi beberapa variable menghasilkan model prediksi kejadian TVD pada tumor ganas ovarium yang mencakup metastasis jauh OR 28,99; IK 95 3,83-219,52, IMT ge; 22,7 kg/m2 OR 15,52, IK 95 2,24-107,37 , kadar D-Dimer ge; 1700 mg/ml OR 13,30, IK 95 2.40-73,84 , stadium lanjut OR 6,66; IK 95 1,05-42,27 , histologi epithelial OR 6,5; IK 95 0,34-125,75 , diameter tumor ge; 18,25 cm OR 2,36, IK 95 0,48-11,54 , adanya komorbid OR 2,49, IK 95 0,53-11,66. Skor prediksi kejadian TVD adalah skor 3 untuk metastasis jauh, IMT ge; 22,76 kg/m2, D dimer ge; 1700 mg/dl, skor 2 untuk stadium lanjut, skor 1 untuk komorbid, diameter tumor ge; 18,25 cm, histologi epitelial dan skor 0 jika tidak ditemukan factor risiko atau nilai variable dibawah titik potong. Skor ge; 8 dari 14 adalah skor minimum dengan nilai prediksi TVD yang baik dengan AUC 0,92 IK 95 0,86-0,98, probabilitas 86,46, sensitivitas 64.7, spesifisitas 90.7. KESIMPULAN: Model prediksi kejadian TVD dapat membantu memprediksi pasien tumor ganas ovarium yang berisiko tinggi untuk mengalami TVD sehingga dapat dipertimbangkan pencegahan TVD selektif.

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BACKGROUND: Malignancy increase the risk of venous thromboembolism around 2 7 fold. Its incidence in ovarian malignancy ranged within 5 29 . Various characteristics related to patients age, body mass index, comorbid , tumor stage, tumor diameter, histology, ascites, distant metastasis or treatment length of surgery, bleeding, transfusion were found as predictor of venous thromboembolism. Predictor model of DVT occurrence in ovarian malignant tumor especially in Indonesian population is still limited.

OBJECTIVE: To evaluate the prediction model of deep vein thrombosis DVT in ovarian malignant tumor.

METHOD: This prospective cohort study enrolled 116 patients with suspected ovarian malignant tumor. Suspected risk factors of venous thromboembolism such as age, body mass index BMI , comorbid, pretreatment D dimer, fibrinogen, thrombocyte level, tumor diameter, staging, presence of distant metastasis, ascites, tumor histopathology, length of surgery, intraoperative blood loss and blood transfusion were measured and recorded. Patient who had symptoms and signs of DVT was confirmed with Doppler ultrasonography.

RESULT: Incidence of symptomatic DVT was 16.5 and 88.2 cases occurred before surgery. No case of symptomatic DVT was observed during post operative hospitalization with mean length of stay 8.85 days. Predictor factor of DVT were distant metastasis OR 28,99 95 CI 3,83 219,52, BMI ge 22,7 kg m2 OR 15,52, 95 CI 2,24 107,37 , D Dimer ge 1700 mg ml OR 13,30, 95 CI 2.40 73,84, advanced stage OR 6,66 95 CI 1,05 42,27 , epithelial tumor OR 6,5 95 CI 0,34 125,75, tumor diameter ge 18,25 cm OR 2,36, 95 CI 0,48 11,54, comorbid OR 2,49, 95 CI 0,53 11,66. Prediction score of DVT were score 3 for distant metastasis, BMI ge 22,7 kg m2, D Dimer ge 1700 mg ml, score 2 for advanced stage, score 1 for tumor diameter ge 18,25 cm, comorbid, epithelial tumor and score 0 for the absence of variables or value of variable was less than the cut off. Total score ge 8 of 14 is the least score which has a good predictive value for DVT ocurence with AUC 0.92, 95 CI 0.86 0.92, probability 86,46, sensitivity 64.7, specificity 90.7.

CONCLUSION: Prediction model of DVT may help to predict the patient with malignan ovarian tumor who had high risk of DVT therefore can consider selective DVT prevention."