Hasil Pencarian  ::  Simpan CSV :: Kembali

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksi sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya. Kejadian malnutrisi yang tinggi pada pasien paru dapat berakibat lamanya rawat inap, turunnya kualitas hidup, dan dapat memengaruhi keberhasilan terapi kanker sehingga terapi nutrisi yang cepat dan tepat sangat perlu dilakukan. Salah satu diagnostik status gizi pada penderita kanker yaitu dengan menggunakan kriteria ASPEN yang terdiri dari penurunan asupan, penurunan berat badan, penurunan massa otot dan massa lemak subkutan, akumulasi cairan general atau lokal, dan kapasitas fungsional. Dikatakan malnutrisi jika terdapat dua dari enam kriteria tersebut. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui hubungan status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Data diambil dari wawancara, pemeriksaan fisis, pemeriksaan laboratorium, dan rekam medis pasien poliklinik onkologi RSUP Persahabatan (n =52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Pada penelitian ini subjek dengan nilai rasio netrofil limfosit tinggi sebanyak 38,5% dan rendah sebanyak 61,5%. Tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

---

Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of lung cancer patients decreases and affects their nutritional status. High incidence of malnutrition in lung cancer patients can result in length of stay, decreased quality of life, and can affect the treatment of cancer therapy, therefore prompt and appropriate nutritional therapy is essential. One of the diagnostics of nutritional status for lung cancer patients is by using the ASPEN criteria which consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be seen if there are two of the six criteria. This study is a cross-sectional study which aimed to determine the association between nutritional status and the ratio of lymphocyte neutrophils in lung cancer patients at Persahabatan Hospital. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology polyclinic of Persahabatan Hospital (n = 52). The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. The subjects with the highest neutrophil lymphocyte ratio value were 38.5% and the lowest value were 61.5%. Overall, there was no relationship between nutritional status and the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksia sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya.  Penelitian ini bertujuan untuk mengetahui hubungan antara status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Penelitian ini menggunakan desain cross-sectional. Data diambil dari wawancara, pemeriksaan fisik, pemeriksaan laboratorium, dan dari rekam medis pasien poliklinik onkologi RSUP Persahabatan (n=52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Sebagai kesimpulan tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

---

Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of patients with lung cancer decreases and affects their nutritional status. This study aims to determine the association between nutritional status and the ratio of lymphocyte neutrophils in patients with lung cancer at Persahabatan Hospital. This is a cross-sectional study. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology clinic of Persahabatan Hospital (n = 52) The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. In conclusion, there was no relationship between nutritional status with the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"LATAR BELAKANG: Gaster merupakan organ pencernaan yang salah satu fungsinya sebagai penampung makanan. Keganasan dapat terjadi di sepanjang saluran pencernaan termasuk gaster. Operasi merupakan salah satu modalitas terapi yang dipakai sebagai terapi keganasan gaster. Penderita keganasan gaster akan mengalami perubahan status gizi. Data mengenai gambaran status gizi pasien yang menjalani operasi keganasan gaster belum ada di RSCM. METODE: Jenis penelitian ini adalah deskriptif retrospektif dengan mengumpulkan data rekam medis pada pasien dengan diagnosis keganasan gaster yang menjalani operasi di Rumah Sakit dr Cipto Mangunkusumo selama periode tahun 2009 sampai dengan 2012. HASIL: Dari 30 pasien yang didiagnosis keganasan gaster , didapatkan data yang lengkap 19 (63,3 %). Penderita laki laki, usia tua dan jenis keganasan dominan pada penelitian ini sesuai dengan penelitian Leonard A Laisang tahun 2008 dan kepustakaan.5,19 Terdapat peningkatan jumlah operasi pada kegansan gaster dari tahun 2009 sampai dengan 2011 namun terjadi penurunan pada tahun 2012. Rerata waktu tunggu operasi cukup lama sampai 14,15 hari sedangkan rerata lama rawat 28 hari. Kebanyakan pasien berdomisili di jabodetabek dan sepertiganya dari luar jawa. Jenis operasi kebanyakan adalah parsial gastrektomi baik dengan bypass atau tidak. Perbandingan rerata albumin dan IMT saat masuk rumah sakit, sebelum operasi dan setelah operasi mengalami penurunan. Sedangkan perbandingan rerata Total Limfosit Count saat masuk rumah sakit dan sebelum operasi mengalami penurunan dan meningkat kembali setelah operasi. Pada penelitian ini terdapat dua kali lipat pasien menderita malnutrisi dibandingkan penelitian oeh Rofi dan Kalis.15,16. SIMPULAN: Kelengkapan data mengenai status nutrisi pada status rekam medis sangat diperlukan. Hasil penelitian bersesuaian dengan kepustakaan dan penelitian sebelumnya.5,19 Lamanya menunggu operasi dan lama rawat memerlukan perhatian khusus untuk menguranginya.

---

BACKGROUND: Gaster is a digestive organ that is one of its functions as a container for food. Malignancy may occur along the digestive tract, including the stomach. Operation is one that is used as a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancy will change the nutritional status. Data on the picture of the nutritional status of patients who underwent surgery for gastric malignancy not yet available at RSCM.

METHOD: This research is a descriptive retrospective medical record by collecting data on patients with a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. Cipto Mangunkusumo during the period from 2009 to 2012.

THE RESULT: Of the 30 patients diagnosed with gastric malignancy, obtained complete data 19 (63.3%). Patients men, old age and type of malignancy dominant in this study is consistent with research Leonard A Laisang 2008 and literature. 5.19 There are an increasing number of operations on gastric malignancy from 2009 to 2011 but decreased in 2012. The mean waiting time operation long enough to 14.15 days, while the average length of 28 days. Most patients live in Jabodetabek and a third from outside Java. This type of surgery is mostly partial gastrectomy with bypass or not. A comparison of the albumin and BMI at admission, before surgery and after surgery decreased. Meanwhile, the average ratio of Total Lymphocyte Count on admission and before surgery decreased and increased again after the operation. In this study, there are two-fold compared to patients suffering from malnutrition research by Rofi and Kalis.15,16.

CONCLUSION: Completeness of data on nutritional status on the status of medical records is needed. Results consistent with the literature study and research previously.5,19 The waiting list of surgery and length of stay require special attention to reduce it."

"Homeostasis protein berperan penting dalam memperlambat proses malnutrisi dan dalam mempertahankan massa bebas lemak pasien kanker. Kehilangan signifikan massa bebas lemak terutama massa otot skelet akan mengurangi mobilitas fisik, kapasitas fungsional, dan skor kualitas hidup pasien kanker. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui korelasi antara asupan protein dengan massa bebas lemak dan kapasitas fungsional pada pasien kanker paru di poli onkologi RS Persahabatan Jakarta. Didapatkan 52 subjek laki-laki dengan rerata usia 55,63 6,77 tahun. Jenis dan stadium kanker yang terbanyak ditemukan adalah adenokarsinoma 63,5, stadium IV 65,4. Status nutrisi kurang berdasarkan IMT ditemui pada 21,2 subjek, dan berdasarkan kadar albumin serum didapatkan 30,8 subjek dengan hipoalbuminemia. Lebih dari 50 subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Pada pemeriksaan komposisi tubuh didapatkan rerata massa bebas lemak 47,20 6,28 kg, dengan 48,1 indeks massa bebas lemak rendah, massa otot rerata 44,74 5,98 kg dengan 40,4 massa otot tergolong kurang. Nilai kapasitas fungsional skala Karnofsky.

---

The homeostasis of protein plays an important role in decreasing the process of malnutrition and in maintaining fat free mass in cancer patients. The significant loss of fat free mass, especially skeletal muscle mass could decrease physical activity, functional capacity, and quality of life of cancer patients. This was a cross sectional study aimed to investigate the correlation of protein intake, fat free mass and functional capacity in lung cancer patients in the Oncology Unit of Persahabatan Hospital Jakarta. Obtained 52 male subjects with a mean age of 55,63 6,77 years old. The most cancers type were adenocarcinoma 63,5 and most of subjects were at stage IV 65,4 . Nutritional status of the subjects 21,2 were in undernutrition based on body mass index parameter, and 30,8 of the subjects were in hypoalbuminemia. More than 50 of the subjects had low energy and protein intake. The mean of fat free mass was at 47,20 6,28 kg, that 48,1 of fat free mass index were in low categorized, and 40,4 of muscle mass were also in small categorized, that the mean was at 44,74 5,98 kg. Functional capacity Karnofsky scale of the subjects 26,9 showed less than 70. The data showed that the subjects had nutrition problems. This study showed positive and significant correlations between protein intake with fat free mass index r 0,379, p "

"[ABSTRAKPraktik Spesialis Keperawatan Medikal Bedah Kekhususan Respirasi di RSUP Persahabatan Jakarta bertujuan untuk mengaplikasikan peranners spesialis da1am mengelola pasien dengan gangguan sistem respirasi melalui pendekatan Model Adaptasi Roy (MAR). Seorang ners spesialis memiliki target memberikan asuhan keperawatan sebanyak 30 pasien sebagai resume dan 1 pasien sebagai laporan kelolaan utama pada pasien kanker paro. Peran ners spesialis juga menerapkan tindakan keperawatan berbasis bukti ilmiah (evidence based musing practice) dengan memberikan latihan progressive muscle relaclation (PMR) dalam mengontrol breathlessness pada pasien kanker peru, Selain itu ners spesialis sebagai pembaharu melakukan inovasi Water Seal Drainoge (WSD) Pionir 1 botol, etas dasar aspek estetika, quality and safety guna meningkatkan kualitas pelayanan keperawatan dan rumah sakit. Hasil praktik menunjukkan bahwa MAR. Efektif digunakan pada pasien dengan gangguan sistem respirasi dan PMR memiliki kecenderungan mengon1ro1 breathlessness pada pasien kanker pam dan kegiatan inovasi mendapat respon positif dari pibak rumah sakit untuk menjadi agenda penelitian bersama.

---

ABSTRACTSurgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda., Surgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda.]"

"Latar Belakang: Mendeteksi risiko kejadian malnutrisi didapat dirumah sakit pada anak dapat dilakukan dengan menggunakan alat penilaian nutrisi yang dilakukan selama masa rawat anak di rumah sakit. Salah satu alat penilaian yang telah dihasilkan berupa Alarm Malnutrisi. Penelitian ini bertujuan untuk menguji nilai sensitivitas dan spesifisitas alat penilaian Alarm Malnutrisi dalam mendeteksi risiko kejadian malnutrisi didapat di rumah sakit yang dibandingkan dengan alat penilaian Screening Tool for the Risk On Nutritional Status and Growth (STRONGKids).Metode Penelitian: Penelitian dengan desain Cross Sectional ini melibatkan 168 anak yang dirawat di rumah sakit berusia 1 bulan hingga 18 tahun. Analisis data menggunakan pendekatan penelitian diagnostik yang menghasilkan nilai uji sensitivitas dan uji spesifisitas.Hasil: Hasil uji statistik menunjukan nilai uji sensitivitas dan uji spesifisitas Alarm Malnutrisi masing-masing sebesar 32,2% dan 81,6%. Hasil ini dinilai tidak begitu baik dibandingkan alat penilaian STRONGKids yang sebelumnya telah dipakai di rumah sakit.Kesimpulan: Alarm Malnutrisi masih perlu dikembangkan dan diperbaiki kembali untuk penyempurnaan sehingga dapat dipakai dengan baik dalam menilai risiko malnutrisi didapat di rumah sakit

---

Background: Detecting the risks for hospital-acquired malnutrition in children can be performed by using nutritional screening tools. One of the screening tools that has been created is Alarm Malnutrisi. This study aimed to test the sensitivity and specificity of Alarm Malnutrisi in detecting the risks for hospital-acquired malnutrition in comparison to Screening Tool for the Risk On Nutritional status and Growth (STRONGkids).

Materials and Method: This study employed cross sectional design and involved 168 hospitalized children (1 month to 18 years) at pediatric ward . The data were analyzed using diagnostic approach which resulted in sensitivity and specificity values.

Results: The statistical tests showed that the sensitivity and specificity values of Alarm Malnutrisi were 32,2% and 81,6% respectively meanwhile the values of STRONGKids. These results indicated that this screening tool was not better than STRONGkids which has been previously used in the Dr. Cipto Manunkusumo Hospitals in Indonesia.

Conclusions: Alarm Malnutrisi needs to be developed and improved in order to achieve better performance in detecting the risks for hospital-acquired malnutrition."

"Kanker paru merupakan penyakit dengan prevalensi, morbiditas, dan mortalitasnya yang tinggi, dengan beban biaya terkait kanker merupakan salah satu yang tertinggi. Financial toxicity merupakan istilah yang menggambarkan dampak dari tingginya biaya terkait kanker. Beban finansial yang tinggi ini berhubungan dengan kualitas hidup yang rendah, gangguan fungsi sosial, hingga penurunan kepatuhan pengobatan. Oleh karena itu, peneliti ingin mencari tahu mengenai gambaran biaya out-of-pocket dan financial toxicity pasien kanker paru di Indonesia serta faktor yang memengaruhinya. Penelitian dilakukan dengan desain studi cross-sectional di RSUP Persahabatan Jakarta dengan metode wawancara di Poli Onkologi Paru, One Day Care, serta bangsal rawat inap untuk mendapat data sosiodemografis, biaya out-of-pocket, dan kondisi financial toxicity dan data karakteristik klinis dari rekam medis. Skor financial toxicity diukur dengan kuesioner FACIT-COST (Versi 2) versi Bahasa Indonesia. Pasien kanker paru di RSUP Persahabatan Jakarta memiliki rerata biaya out-of-pocket per bulan dengan rentang dari Rp54.166,00 hingga Rp19.749.166,00 dan sebanyak 58,3% dari pasien kanker paru tersebut mengalami toksisitas finansial. Hasil analisis bivariat menunjukan hubungan yang bermakna antara durasi sejak diagnosis (p=0,019), biaya out-of-pocket (p=0,035), dan persentase biaya out-of-pocket per pemasukan (p=0,012) dengan kondisi financial toxicity. Biaya out-of-pocket pasien kanker paru dapat digolongkan sebagai biaya katastrofik dan berpengaruh pada kondisi financial toxicity pasien.

---

Lung cancer has high prevalence, morbidity, mortality, and is one of the highest costing disease with not all costs are covered by insurance. Financial toxicity describes the impact of the high financial burden of cancer. High financial burden is associated with lower quality of life, impaired social functioning, and lower compliance to treatment. Therefor, researcher wanted to look into the out-of-pocket costs and financial toxicity in lung cancer patients and its associated factors. The study is done cross-sectionally in RSUP Persahabatan Jakarta by interviewing patients in Lung Oncology outpatient clinic, ODC unit, and inpatient wards to get sociodemographic, out-of-pocket cost, and financial toxicity data. Datas on clinical characteristics were obtained from patients’ medical records. Financial toxicity was measured using the Indonesian version of FACIT-COST (Version 2) questionnaire. Lung cancer patients at RSUP Persahabatan’s out-of-pocket cost ranges from Rp54.166,00 to Rp19.749.166,00 and 58,3% of patients reporting financial toxicity. Analysis showed significant associations between duration since diagnosis (p=0,019), out-of-pocket cost (p=0,035), and percentage of out-of-pocket cost per income (p=0,012), and financial toxicity. Out-of-pocket cost of lung cancer patients can be classified as catastrophic cost and is related to financial toxicity. "

"Latar belakang: Pneumonia terjadi pada sekitar 50-70% pasien kanker paru. Kerentanan pneumonia terjadi akibat gangguan sistem imun dan arsitektur paru yang terjadi karena mekanisme kanker maupun terapi kanker paru. Perubahan imunitas menyeluruh, kaheksia, terapi, perubahan arsitektur paru merupakan faktor-faktor yang dapat menyebabkan inflamasi hingga penurunan imunitas yang dapat menimbulkan kejadian pneumonia pada kanker paru. Pasien kanker paru dengan pneumonia memiliki kesintasan satu tahun yang lebih buruk dan mortalitas satu tahun yang lebih tinggi dibandingkan tanpa pneumonia. Metode: Sampel penelitian merupakan pasien kanker paru tegak jenis yang datag ke IGD RSUP Persahabatan. Jumlah sampel sebanyak 77 pasien diambil secara consecutive sampling periode Januari-Februari 2024. Setiap sampel dilakukan anamnesis serta pemeriksaan fisis untuk mendapatkan data klinis, pemeriksaan laboratorium darah, foto toraks dan pemeriksaan biakan sputum. Pasien dilakukan pengamatan selama perawatan untuk melihat luaran pasien saat keluar rumah sakit. Hasil: Sebanyak 81,1% sampel mengalami pneumonia. Luaran meninggal sebanyak 24,7% dan 30,2% sampel yang mengalami pneumonia memiliki luaran meninggal. Faktor risiko seperti Riwayat merokok, jenis kanker paru, lokasi kanker paru, jumlah leukosit, jumlah neutrofil, RNL dan PCT menunjukkan tidak terdapat hubungan bermakna terhadap kejadian pneumonia (p>0,05). Klebsiella pneumoniae, Acinetobacter baumanii dan Escerichia coli merupakan jenis kuman terbanyak hasil biakan sputum. Kesimpulan: Lebih dari setengah jumlah pasien kanker paru yang masuk ke IGD RSUP Persahabatan mengalami infeksi pneumonia. Tidak terdapat hubungan bermakna faktor risiko terhadap kejadian kanker paru. Klebsiella pneumoniae merupakan jenis mikroorganisme terbanyak penyebab pneumonia berdasarkan hasil biakan sputum pasien kanker paru.

---

Background: Pneumonia occurs in around 50-70% of lung cancer patients. Pneumonia susceptibility occurs due to disorders of the immune system and lung architecture that occur due to cancer mechanisms and lung cancer therapy. Changes in overall immunity, cachexia, therapy, and changes in lung architecture are factors that can cause inflammation and decreased immunity which can lead to pneumonia in lung cancer. Lung cancer patients with pneumonia had worse one-year survival and higher one-year mortality than those without pneumonia. Method: The research sample was lung cancer patients who were confirmed pathologically and came to the emergency room at Persahabatan Hospital. The total number of samples was 77 patients taken by consecutive sampling for the period January-February 2024. Anamnesis and physical examination were carried out for each sample to obtain clinical data, blood laboratory examination, chest x-ray and sputum culture examination. Patients are monitored during treatment to see the patient's outcome when they leave the hospital. Results: As many as 81.1% of the sample experienced pneumonia. The outcome of death was 24.7% and 30.2% of samples who experienced pneumonia had a death outcome. Risk factors such as smoking history, type of lung cancer, location of lung cancer, leukocyte count, neutrophil count, RNL and PCT showed no significant relationship to the incidence of pneumonia (p>0.05). Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli are the most common types of germs resulting from sputum culture. Conclusion: More than half of lung cancer patients admitted to the emergency room at Persahabatan Hospital have pneumonia infections. There was no significant relationship between risk factors and the incidence of lung cancer. Klebsiella pneumoniae is the most common type of microorganism resulting from sputum culture of pneumonia patients with lung cancer"

"ABSTRAKLatar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS

---

ABSTRAK Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS ."

"ABSTRAKPendahuluan: Infeksi paru merupakan penyebab morbiditas dan mortalitas terbesar di Intensive Care Unit ICU. Pasien ICU umumnya dalam kondisi critically ill dan riwayat penggunaan antibiotic sebelumnya sehingga memiliki risiko resistensi terhadap antibiotik yang berpengaruh terhadap luaran pasien.Sistem skoring digunakan di ICU untuk menilai derajat keparahan penyakit dan luaran pasien. Penelitian ini menilai eta kuman pasien infeksi paru dan hubungannya dengan derajat keparahan penyakit yang dinilai dengan skor APACHE II. Metode: Penelitian ini menggunakan metode potong lintang yang dilaksanakan pada bulan Agustus-September 2017 di ICU RSUP Persahabatan. Total subjek terdiri atas 59 subjek dengan cara pengambilan sampel consecutive sampling. Semua pasien didiagnosis infeksi paru oleh dokter spesialis dan dikonfirmasi melalui foto toraks kemudian dinilai derajat keparahan penyakit dengan skor APACHE II dan dilakukan biakan dan resistensi mikroorganisme. Hasil: Kuman yang banyak ditemukan merupakan gram negative (37,2%) dengan risiko mortalitas tertinggi 75% jenis Acinetobacter pada skor (APACHE II 30-34). Rerata skor APACHE II 15,78+ 6,04 dengancut off point skor APACHE II 16,5 dan skor APACHE II >16 memiliki mortalitas terbesar (64%) (p=0,032). Diagnosis infeksi paru dengan mortalitas terbesar didapatkan pada CAP (56%). Kesimpulan: Acinetobacter baumanii merupakan kuman terbanyak yang menyebabkan kematian pada pasien infeksi paru dan skor APACHE II merupakan prediktor yang baik dalam menilai derajat keparahan penyakit dan luaran pasien.

---

ABSTRACT<>br>Introduction: Lung infection are the most common cause of high mortality and morbidity in Intensive Care Unit (ICU). Patients in ICU mostly critically ill with history of antibiotic use and risk of drug resistant that will influence the outcome of the patients. Scoring system used in ICU to measure severity of the disease and the outcome of the patients. This study asseses the microbiological pattern of patients with lung infection and severity of the disease using APACHE II Score. Methods: This study used cross sectional methods that heldbetween August 2017-September 2017in Persahabatan Hospital Intensive Care Unit. Total subjects consisted of 59 patients with lung infection base on consecutive sampling. All of the patients diagnosed with lung infection from specialist and confirmed with radiological findings, measured the APACHE II Score and performed sputum culture and resistance. Results: The most common isolation found in lung infection patients was gram negative (37,2%) with mortality risk of Acinetobacter baumanii75% (APACHE II Score 30-34). Mean APACHE II Score was 15,78+ 6,04 with cut off point APACHE II Score 16,5 and APACHE II Score > 16 has the highest mortality (64%) (p=0,032). Diagnose of lung infection with the highest mortality found in patients with CAP (56%). Conclusions: Acinetobacter baumanii are the most common cause of mortality in lung infection patients. The APACHE II Score has good predictor in measure severity of the diseases and the outcome of the patients."