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"Latar belakang: Basis data bagian Bedah Jantung Anak RSPJNHK menunjukkan terdapat 133 pasien TGA IVS yang dilakukan ASO primer. Terdapat mortalitas tinggi yaitu 9% dibandingkan dengan mortalitas yang pernah dilaporkan sebelumnya yaitu 5%. Telah banyak penelitian yang memperlihatkan faktor risiko yang memengaruhi keluaran ASO primer pada TGA IVS late presenter, tetapi belum terdapat penelitian yang melaporkan keluaran prosedur tersebut di Indonesia. Jumlah kasus yang banyak di Indonesia dan tingkat mortalitas operasi yang masih tinggi menjadi alasan untuk mencari faktor risiko yang memengaruhi keluaran tersebut. Metode: Penelitian ini adalah penelitian kohort retrospektif yang melibatkan pasien TGA-IVS late presenter yang menjalani ASO primer pada tahun 2015-2022 di Rumah Sakit Pusat Jantung Nasional Harapan Kita (RSPJNHK). Variabel yang dinilai meliputi faktor praoperasi seperti usia, indeks massa ventrikel kiri, diameter dinding posterior ventrikel kiri serta faktor intraoperasi seperti lama penggunaan CPB dan klem silang aorta. Analisis bivariat dan multivariat dilakukan untuk menilai hubungan faktor risiko tersebut dengan kejadian mortalitas dini. adjusted Odds Ratio (aOR) dinilai untuk mengidentifikasi seberapa besar pengaruh faktor risiko tersebut apabila faktor lain disamakan (adjusted) Hasil: Terdapat 88 subjek yang diikutsertakan dalam penelitian ini. Median usia subjek adalah 7,2 (4-365) minggu. Kejadian morbiditas dini dialami oleh 11,7% subjek. Indeks massa ventrikel kiri merupakan faktor risiko independen yang memengaruhi keluaran mortalitas dini pasien TGA IVS late presenter yang menjalani ASO primer dengan nilai p = 0,003 serta aOR 14,02 (2,4-83,8). Lama penggunaan klem silang aorta dan mesin CPB memengaruhi keluaran mortalitas dini dengan nilai p 0,035 dan 0,011. Usia dan diameter dinding posterior ventrikel kiri tidak memengaruhi keluaran mortalitas dini pasien TGA IVS late presenter yang menjalani ASO primer. Kesimpulan: Indeks massa ventrikel kiri merupakan faktor independen yang memengaruhi mortalitas dini pada pasien TGA-IVS late presenter yang dilakukan ASO primer. Sedangkan lama penggunaan klem silang aorta dan lama penggunaan mesin CPB menjadi faktor risiko yang memengaruhi mortalitas dini untuk ASO primer pada Transposition Great Arteries–Intact Ventricular Septum late presenter.

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Background: The Pediatric Cardiac Surgery database of RSPJNHK showed that there were 133 TGA-IVS patients who underwent primary ASO. There was a high mortality rate of 9% compared to the previously reported mortality rate of 5%. There have been many studies showing risk factors affecting the outcome of primary ASO in TGA IVS late presenters, but there are no studies reporting the outcomes of the procedure in Indonesia. The large number of cases in Indonesia and the high operative mortality rate are the reasons to search for risk factors affecting the outcomes. Methods: This study was a retrospective cohort study involving the Primary Arterial Switch Operation for Late Presentation of Transposition of the Great Arteries With Intact Ventricular Septum between 2015 and 2022 at Harapan Kita National Heart Center Hospital (RSPJNHK). The variables assessed included preoperative factors such as age, left ventricular mass index, and left ventricular posterior wall diameter, and intraoperative factors like the duration of CPB use and aortic cross-clamp time. Bivariate and multivariate analyses were conducted to evaluate the association of these risk factors with the incidence of early mortality. The adjusted Odds Ratio (aOR) was calculated to determine the extent of influence these risk factors had when other variables were controlled for. Results: A total of 88 subjects were included in this study. The median age of the subjects was 7.2 (4-365) weeks. Early morbidity events were experienced by 11.7% of subjects. Left ventricular mass index was an independent risk factor affecting early mortality outcomes of late presenter TGA IVS patients undergoing primary ASO with a p value = 0.003 and aOR 14.02 (2.4-83.8). Length of use of aortic cross clamp and CPB machine influenced early mortality outcomes with p values of 0.035 and 0.011. Age and left ventricular posterior wall diameter did not affect early mortality outcomes of late presenter TGA IVS patients undergoing primary ASO. Conclusion: Left ventricular mass index, is an independent risk factor that affect early mortality of patient with TGA-IVS late presenter underwent primary ASO. While duration of aortic cross clamp use, and duration of CPB machine use are risk factors that affect early mortality of the Primary Arterial Switch Operation for Late Presentation of Transposition of the Great Arteries With Intact Ventricular Septum."

"Transposition of Great Arteries (TGA) adalah kelainan penyakit jantung bawaan sianotik kedua yang paling sering ditemukan. Tatalaksana definitif saat ini adalah Arterial Switch Operation (ASO). Angka mortalitas pasca ASO di negara maju cukup rendah, sementara di negara berkembang sekitar 15%. Pada TGA Intact Ventricular Septum (TGA IVS), sebaiknya ASO dilakukan ≤ 3 minggu. Sedangkan, di negara berkembang, karena berbagai hal multifaktorial, ASO sering dilakukan saat usia > 3 minggu. Pengaruh usia saat operasi > 3 minggu terhadap kelangsungan hidup jangka panjang sampai saat ini masih kontroversial. Penelitian ini bertujuan untuk mengetahui pengaruh usia saat operasi > 3 minggu terhadap kelangsungan hidup 10 tahun pasien TGA yang menjalani operasi ASO. Penelitian ini merupakan studi kohort retrospekstif yang dilakukan pada pasien TGA IVS yang keluar hidup setelah operasi ASO selama periode Januari 2008-Desember 2018. Pasien kemudian dilakukan follow up untuk mengetahui kondisi hidup dan meninggal. Analisis waktu terjadinya event ditentukan berdasarkan titik awal dan titik akhir penelitian. 71,9 % pasien menjalani operasi ASO > 3 minggu. Angka kelangsungan hidup 10 tahun keseluruhan pasien pasca operasi Arterial Switch Operation sebesar 90%. Walaupun mean survival time kelompok usia operasi ≤ 3 minggu lebih panjang dibandingkan dengan kelompok usia operasi > 3 minggu (113 bulan vs 107 bulan), tetapi secara statistik tidak berbeda bermakna. Usia saat operasi > 3 minggu mempunyai risiko meningkatkan risiko kematian sebesar HR 0,49 (IK95% 0,11-2,27; p=0.86).

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Transposition of Great Arteries (TGA) is the second most common found cyanotic congenital heart disease. The current definitive management is Arterial Switch Operation (ASO). Early and long term mortality rates after ASO in developed countries are quite low, while in developing countries the number is around 15%. In TGA Intact Ventricular Septum (TGA IVS), ASO should be done in ≤ 3 weeks. However, in developing countries, due to various multifactorial causes, it is often being done at the age of > 3 weeks. The effect of age at surgery > 3 weeks on long-term survival is still controversial. This study aims to determine the effect of age at surgery and other factors on the 10-year survival of patients after ASO. A retrospective cohort study was done on TGA IVS patients that survived ASO surgery during the period of January 2008-December 2018. Patients were being followed up to find out if they are still alive. Analysis of the time to evaluate the event is determined based on the starting point and end point of the study. 71,9% patients underwent ASO surgery > 3 weeks. The overall 10-year survival rate of patients after Arterial Switch Operation is 90%. Even though the mean survival time of the operating age group ≤ 3 weeks is longer than the operation age group > 3 weeks (113 months vs 107 months), but it is not statistically significant. Age at surgery > 3 weeks had a risk of increasing the risk of death by HR 0,49 (IK95% 0,11-2,27; p=0.86).

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"Latar belakang: Arterial Switch Operation (ASO) merupakan prosedur utama pada Transposition Intact Ventricular Septum (TGA-IVS). TGA-IVS kehadiran terlambat (usia ≥30 hari) mempengaruhi kesintasan pascaprosedur ASO dan umum ditemukan di negara berkembang, termasuk Indonesia. Semakin besar usia pada populasi penyakit jantung kongenital, terutama TGA-IVS, umumnya disertai status gizi kurang. Hubungan antara status gizi terhadap kesintasan pascaprosedur ASO pada TGA-IVS kehadiran terlambat belum diketahui Metodologi: Penelitian studi potong lintang berdasarkan data sekunder dari rekam medis pada pasien TGA-IVS≥ 30 hari yang menjalani operasi ASO periode 2015-2021.Variabel utama yang dinilai adalah status gizi berdasarkan kurva status gizi WHO 2006 Variabel yang ikut dinilai antara lain usia, jenis kelamin, anomali koroner, pola anomali, jenis ASO, lama penggunaan mesin jantung paru, dan penggunaan klem silang aorta terhadap mortalitas pascaprosedur ASO. Hasil: Terdapat 89 anak dengan kehadiran terlambat; 68,53% memiliki status gizi kurang/buruk. Karakteristik pasien TGA-IVS kehadiran terlambat adalah laki-laki (67,2-67,9%), tidak memiliki anomali koroner dan memiliki pola anomali koroner normal (67,2-78,6%) dan menjalani ASO primer (67,9-68,9%). Status gizi kurang/buruk tidak memiliki hubungan terhadap risiko kemation pascaprosedur ASO (OR: 2,41, P:0,661) dibandingkan status gizi cukup. Lama mesin jantung paru merupakan prediktor mortalitas independen (p = 0,031) Kesimpulan: Status gizi rendah tidak memilki hubungan terhadap mortalitas pascaprosedur ASO pada TGA-IVS kehadiran terlambat.

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Background: Arterial Switch Operation (ASO) is the main procedure for Transposition of with Intact Ventricular Septum (TGA-IVS). Late presenter TGA-IVS (age ≥30 days) has lower postoperative ASO survival and commonly found in developing country, including Indonesia. Older age in congenital heart disease, including TGA-IVS, associated with poor nutritional status. The correlation between nutritional status and mortality post ASO in late presenter TGA-IVS remains unknown. Method: a cross sectional study based on secondary data based on medical record of late presenter TGA-IVS who undergoned ASO in 2015-202. The main measured variable is nutritional status based on WHO 2006 nutritional status curves. Other measured variables are age at intervention, gender, coronary anomaly, coronary patterns, ASO types, cardiopulmonary bypass time, aortic crosss-clamp time and hospital mortality post ASO Result: 89 children identified as late presenter TGA-IVS; 68,53% with poor nutritional status. The late presenter TGA-IVS characteristics are male (67,2-67,9%), normal coronary anatomy and pattern (67,2-78,6%), and mostly underwent primary ASO (67,9-68,9%). Poor nutritional status has no correlation (OR: 2,41, P:0,661) with mortality outcome post ASO if compared with normal nutritional status. CPB time is an independent risk factor for mortality (p = 0,031). Conclusion: No correlation between poor nutritional status with mortality outcomes post ASO procedure in late presenter TGA-IVS"

"Approximately 120 different surgical procedures are used to correct congenital heart diseases, and the burden that this places on the surgeon is compounded by the exceptional complexity of the techniques and the rarity of many of the lesions. Training is problematic, not least because of legal issues, and currently available texts, drawings, and images are no substitute for real ‘live’ surgery.Against this background, the authors have set out to create an interactive multimedia manual that covers many aspects of congenital heart surgery. Each heart defect is addressed in an individual chapter, elaborating specific surgical anatomy and indication for surgery of heart defect first, followed by video clips depicting the operative approach and technique. The clips are accompanied by a clear descriptive narrative, and patient history and diagnostic images are available to provide a clear backdrop to the operation. "

"ABSTRAK Latar Belakang. Penyakit jantung katup masih banyak ditemui di Indonesia, akan tetapi karena keterbatasan fasilitas kesehatan, banyak pasien yang terlambat mendapatkan intervensi. Keterlambatan intervensi akan mengakibatkan peningkatan morbiditas dan mortalitas. Beberapa studi besar seperti EuroSCORE dan STS telah mengembangkan model prediksi mortalitas pasca pembedahan katup jantung, akan tetapi sedikit sekali studi terkait yang dilakukan di Indonesia, padahal terdapat perbedaan karakteristik pasien. Studi ini bertujuan mengidentifikasi faktor-faktor yang dapat menjadi prediktor kejadian mortalitas di rumah sakit pada pasien yang menjalani pembedahan katup jantung.Metode. Studi kohort retrospektif dilakukan di Pusat Jantung Nasional Harapan Kita, Jakarta pada pasien yang menjalani pembedahan katup jantung.Karakteristik demografi, parameter klinis, data laboratorium, ekokardiografi dan teknis operasi merupakan kategori dari variabel yang dikumpulkan melalui rekam medis dan sistem informasi rumah sakit. Data kemudian diolah dengan analisis multivariat menggunakan metode regresi logistik.Hasil. Sebanyak 305 sampel berhasil dikumpulkan, dengan 24 diantaranya mengalami kematian (7.9%). Variabel yang berkaitan dengan mortalitas adalah kelas fungsional, riwayat diabetes, endokarditis aktif, riwayat operasi jantung sebelumnya, kadar hemoglobin, TAPSE dan durasi CPB dan jenis operasi. Uji diskriminasi dan kalibrasi dari model menunjukkan hasil yang baik.Kesimpulan. Beberapa variabel telah diidentifikasi merupakan prediktor mortalitas pasca operasi katup jantung. Informasi ini diharapkan dapat membantu menentukan strategi tatalaksana selama intervensi dan perawatan

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ABSTRAK Background. Valvular heart disease still become one of the leading heart disease in Indonesia. Unfortunately, because of very limited cardiac centres, many patients diagnosed late. Delay in intervention would increase the morbidity andmortality rate if intervention ultimately performed. Several surgical mortality prediction models such as EuroSCORE and STS had been developed. However, until now, there is no specific mortality risk assessment in our population, despite very different in patients characteristics. Aim of this study is to identify risk factors to predict in-hospital mortality in patient underwent heart valve surgery Methods. A retrospective cohort study, done in National Cardiovascular Center Harapan Kita, Jakarta in patients underwent heart valve surgery. Categories for data obtained was basic characteristics, clinical examinations, echocardiography and operation procedure. Statistical analysis was done using multivariat analysis using logistic regression method.Result. 305 subjects fit the inclusion and exclusion criteria. Mortality event occured in 24 patients (7.9%). The variables are functional class III or IV, diabetes, active endocarditis, previous open heart surgery, hemoglobin level, TAPSE, CPB time and type of operation. Calibration and discrimination test of prediction model shows good result.Conclusion. Several variables has been identified as predictor of in-hospital mortality after heart valve surgery. These information are expected to be helpful in deciding intervention and treatment strategies."

"Latar belakang: Model prediksi risiko operasi memiliki peranan penting pada tindakan operasi katup jantung. Perubahan karakter pasien dan fasilitas pembedahan dalam waktu tertentu dapat mempengaruhi nilai prediksi skor risiko operasi.Tujuan: Mengetahui perbandingan validasi EuroSCORE II, skor Ambler dan skor Harapan Kita dalam memprediksi mortalitas di rumah sakit pasca operasi katup jantung.Metode: Dilakukan studi kohort retrospektif terhadap 416 pasien yang menjalani operasi katup jantung pada periode November 2018 hingga Desember 2019. Data berasal dari rekam medis dengan metode sampling konsekutif. Didapatkan nilai kalibrasi dan diskriminasi EuroSCORE II, skor Ambler dan skor Harapan Kita.Hasil: Angka kematian yang diobservasi sebesar 6,7%. EuroSCORE II, skor Ambler and skor Harapan Kita memiliki kalibrasi yang baik (uji Hosmer-Lemeshow p=0,065, p=0,233 and p=0,314). Kemampuan diskriminasi skor dalam memprediksi kematian di rumah sakit EuroSCORE II (AUC 0,763; 95% IK;0.660-0.867), diikuti skor Ambler (AUC 0.748; 95% IK; 0.655-0.841) dan skor Harapan Kita (AUC 0,694; 95% IK; 0.584-0.804)Kesimpulan: EuroSCORE II, skor Ambler dan skor Harapan Kita memiliki validasi yang cukup baik. Kalibrasi ketiga skor baik dengan kalibrasi skor Harapan Kita relatif lebih baik dari dua skor lainnya, sedangkan nilai diskriminasi skor Harapan Kita di bawah EuroSCORE II dan skor Ambler.

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Background: Preoperative risk prediction models have important role in cardiac valve surgical management. Changing in patient characteristics and surgical facilities over time, might affect the predicting value of those scoring system.

Objective: This study aimed to compare the validation of EuroSCORE II, Ambler score and Harapan Kita score in predicting in-hospital mortality at patients underwent heart valve surgery

Methods: Cohort restrospective study was performed at 416 patients who underwent heart valve surgery from November 2018 to December 2019. Data was taken from the medical records by consecutive sampling method. The calibration and discrimination value of EuroSCORE II, Ambler score and Harapan Kita score were obtained.

Results: Observed in-hospital mortality was 6,7%. EuroSCORE II, Ambler score and Harapan Kita score have good calibration (Hosmer-Lemeshow test p=0,065, p=0,233 and p=0,314). The discriminative value of these three scores in predicting in-hospital mortality for EuroScore II AUC 0,763 (95% CI; 0.660-0.867), Ambler score AUC 0.748 (95% CI; 0.655-0.841) and Harapan Kita score AUC 0,694 (95% CI; 0.584-0.804)

Conclusion: EuroSCORE II, Ambler score and Harapan Kita score have fairly good validation. Those scoring system have good calibration with Harapan Kita score calibration relatively better than EuroSCORE and Ambler score, meanwhile Harapan Kita score has less discrimination value than EuroScore II and Ambler score."

"ABSTRAKTelah dilakukan penelitian secara retrospektif terhadap 260 penderita yang menjalani bedah pintas koroner di Rumah Sakit Jantung Harapan Kita antara bulan Maret 1986 sampai dengan 31 Maret 1990 untuk mencari variabel prognostik mortalitas bedah.Tiga puluh satu variabel prabedah yang terdiri dart 24 variabel klinis, 7 variabel kateterisasi-angiografi; dan 6 variabel intrabedah, telah diuji secara univariat dengan analisa "Kai-kuadrat" atau "Fisher's exact" dan selanjutnya secara multivariat dengan "Forward stepwise selection".Dari 24 variabel klinik yang dianalisa secara univariat hanya 4 variabel yang bermakna yaitu kelas angina, riwayat CHF, aritmia dan kreatinin. Dari 7 variabel kateterisasi-angiografi tidak satupun yang bermakna. Dari 6 variabel bedah hanya 3 variabel yang bermakna secara univariat yaitu prioritas bedah, lama klem aorta dan endarterektomi. Dari 4 variabel klinik dan 3 variabel bedah yang bermakna tersebut, dengan analisa multivariat hanya 3 variabel yang bermakna yaitu prioritas bedah (p=0,0002), lama klem aorta (p=0,019) dan kreatinin serum (p=0,049).Mortalitas bedah meningkat dengan tindakan urgensi--emergensi (mortalitas elektif 5,7%, mortalitas urgensi 28,0% dan mortalitas emergensi 57,1%). Lama klem aorta juga mempengaruhi mortalitas (mortalitas lame klem aorta < 52 menit 2%, antara 52-70 menit 4,9%, antara 71-96 menit 10,0% dan > 96 menit 22,9%). Kadar kreatinin > 2 mg% menyebabkan mortalitas meningkat (pada kadar kreatinin serum > 2 mg% mortalitasnya 60%).Sebagai kesimpulan bahwa kadar kreatinin serum yang tinggi, pernbedahan secara urgensi-emergensi, dan lama klem aorta yang panjang akan meningkatkan mortalitas bedah.

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ABSTRACTA retrospective study on 260 patients who underwent bypass surgery at the Harapan Kiita National Cardiac Center from March 1986 up to March 1990 was undertaken to determine the prognostic variable in surgical mortality.Thirty one preoperative variables comprising of 24 clinical, 7 coronary angiographies and 6 intraoperative variables were tested using univariate analysis with chi-square or Fisher's exact followed by multivariate analysis using Forward Stepwise Selection.Of 24 variables analyzed using univariate analysis only 4 were significant, namely angina class, history of CHF, arrhythmias and creatinine.Of the 7 angiographies variables, not even one was significant ; whereas of 6 surgical variables, only 3 were significant, that is priority of surgery, duration of aortic clamp and endarterectomy.From 4 clinical and 3 surgical variables which were significant, using multivariate analysis, only 3 were significant: priority of surgery (p=0,0002), duration of aortic clamp (p=0,019), and serum creatinine (p=0,049).Surgical mortality increased with urgency-emergency procedures (elective mortality 5,7%, urgency mortality 28,0% and emergency mortality 57,1%). Duration of aortic clamp also influenced mortality (aortic cross clamp < 521,2%; between 71-96',10,0% ; and > 96',22,9%). 96',22,9%). Serum creatinine level exceeding 2 mg% increased mortality (at a serum creatinine level of > 2 mg%, mortality was 60%).In conclusion, a high serum creatinine level, an urgency-emergency surgical procedure, and the duration of aortic clamp time will increase surgical mortality."

"ABSTRAKLatar belakang: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) merupakan sistem stratifikasi risiko terbaru yang dikembangkan sebagai prediktor mortalitas dan morbiditas pascoperasi penyakit jantung bawaan (PJB), namun belum pernah divalidasi di populasi Indonesia.Tujuan: Melakukan validasi eksternal RACHS-1 pada populasi Indonesia sebagai prediktor mortalitas pascoperasi PJB.Metode: Uji validasi dengan studi kohort, menggunakan data retrospektif dari bank data bagian bedah jantung anak dan kongenital Rumah Sakit Pusat Jantung Nasional Harapan Kita dari Januari 2015-Desember 2019. Uji diagnostik memperlihatkan nilai sensitivitas, spesifisitas dan area under curve-receiving operator characteristic (AUC-ROC) sebagai luaran utama dalam menilai kemampuan prediksi luaran mortalitas.Hasil: Penelitian melibatkan 4139 subjek dengan mortalitas pada 230 subjek (5,6%). RACHS-1 category memiliki sensitivitas 71% dengan spesifisitas 60% dalam memprediksi mortalitas. Kemampuan diskriminasi memperlihatkan hasil yang kurang baik dalam prediksi mortalitas (AUC-ROC 0,673).Kesimpulan: RACHS-1 memiliki kemampuan diskriminasi yang kurang baik sebagai prediktor mortalitas di Indonesia dengan nilai AUC-ROC 0,673.

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ABSTRACTBackground: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) were the latest risk stratification methods for congenital heart disease (CHD) surgery that were developed to predict mortality and morbidity outcome, it hasn't been validated in Indonesian population.Objectives: To validate RACHS-1 category as a predictor of mortality in Indonesia.Methods: A Retrospective Cohort study using the database Pediatric and Congenital Heart Surgery Department of National Cardiovascular Harapan Kita Database from January 2015-December 2019. Statistical analysis was done using area under curve-receiving operator characteristic (AUC-ROC) to determine the predictive discrimination of mortality.Results: This study enrolled 4139 subjects with mortality rate of 230 subjects (5.4%). The RACHS-1 category have the sensitiviy of 71% with specificity of 60% to predict mortality. Both of the methods showed a fine discrimination to predict mortality (AUC-ROC 0.673).Conclusion: RACHS-1 has a poor discrimination ability as a predictor of mortality in Indonesia with an AUC-ROC value of 0.673."

"Latar Belakang: Di negara maju, angka mortalitas gastroskisis adalah 5-10%, berbeda dengan di negara berkembang. Angka mortalitas gastroskisis mencapai 52% di Brazil, 43% di Afrika Selatan, 35% di Iran, dan 79% di Jamaika. Di RSUPN Cipto Mangunkusumo (RSCM), sampai saat ini belum ada data mengenai angka mortalitas gastrosksis. Angka mortalitas gastroskisis di RSCM perlu diketahui karena karakteristik pasien yang diperkirakan berbeda dengan di negara maju. Tujuan dari penelitian ini adalah untuk mengetahui angka mortalitas gastroskisis di RSCM serta mengidentifikasi faktor risiko yang berpengaruh terhadap mortalitas gastroskisis, antara lain: usia kehamilan, berat badan lahir, jumlah operasi, usia saat operasi pertama kali, serta gastroskisis komplikata.Metode: Metode penelitian ini adalah studi kohort retrospektif dengan total sampling seluruh neonatus yang menjalani operasi penutupan defek di RSCM dari Januari 2015 – September 2020. Analisis bivariat dilakukan menggunakan uji Chi Square atau uji Fisher. Didapatkan 49 subjek neonatus dengan 7 data masuk kategori drop out sehingga 42 subjek diambil untuk dianalisis.Hasil: Angka mortalitas neonatus dengan gastroskisis di RSCM tahun 2015-2020 adalah 69% (29 dari 42 subjek). Pada penelitian ini didapatkan usia saat operasi (<1 hari) berpengaruh menurunkan angka mortalitas gastrosksis (p = 0,005). Usia kehamilan, berat badan lahir, jumlah operasi, dan gastroskisis komplikata didapatkan tidak berpengaruh terhadap angka mortalitas gastroskisis.Kesimpulan: Angka mortalitas gastrokisis di RSCM adalah 69% dan dipengaruhi oleh usia saat operasi.

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Background: Unlike developing countries, the mortality rate of gastroschizis in developed countries is much lower, accounting at 5-10%. In developing countries, for example, Brazil, the mortality rate can reach up to 52%, 43% in South Africa, 35% in Iran, and 79% in Jamaica. Until recently, there are no data regarding gastrochizis-related mortality rate in Cipto Mangkunkusumo National Referral Hospital, Indonesia. This is important as it reflects patient characteristics that is different with developed countries. The objective of this research is to find out the mortality rate of gastroschizis in Indonesia along with other possible influencing risk factors such as; gestational age, birth weight, number of operations, age at closure, and the presence of complicated gastroschizis.

Methods: A cohort retrospective study with total sampling is used to document all neonates who undergo defect closure surgery from January 2015 to September 2020. Bivariate analysis is done using Chi Square test or Fisher test. A total of 49 neonates were documented, however 7 neonates were excluded due to drop out criteria, resulting in 42 neonates who were included in the analysis.

Results: The mortality rate of gastroschizis in Cipto Mangkunkusumo National Referral Hospital is 69% (29 out of 42 subjects). The age at closure is related to lower mortality rate (p = 0.005), while other factors such as gestational age, birth weight, number of operations, and the presence of complicated gastroschizis has no impact on mortality.

Conclusions: The mortality rate of gastroschizis in Cipto Mangkunkusumo National Referral Hospital is 69% and is influenced by age at closure."

"Terkait pertambahan usia, penurunan fungsi paru dapat terjadi karena adanya perubahan struktur histologis alveolus. Tujuan penelitian ini adalah : untuk mengetahui korelasi ketebalan septum interalveolar paru tikus Sprague dawley terhadap pertambahan usia. Metode penelitian ini adalah penelitian berbasis laboratorium dengan desain cross sectional. Sebagai subjek penelitian, digunakan tikus Sprague-dawley yang terbagi dalam empat kelompok usia : 2 hari, 16 hari, 3-4 bulan, di atas 12 bulan. Sesuai dengan kelompok usia, kemudian dilakukan pengambilan jaringan paru dan diwarnai dengan metode pewarnaan trichrome-masson. Penghitungan nilai tebal septum dilakukan dengan membandingkan jumlah total tebal septum dengan lebar lapang pandang. Dengan metode saphiro-wilk didapatkan nilai persebaran data yang normal dan dilanjutkan dengan uji korelasi. Hhasil analisis data penelitian yang didapat berdasarkan kelompok usia, diperoleh ketebalan septum alveolus sebesar 0.436 ± 0.059 m untuk kelompok usia 2 hari, 0.399 ± 0.022 m pada kelompok usia 16 hari, 0.474 ± 0.043 m pada kelompok 3-4 bulan, serta 0.512 ± 0.020 m pada kelompok tikus usia lebih dari 12 bulan. Kesimpulan penelitian berdasarkan hasil uji korelasi pearson, diperoleh nilai r=0,375 yang menandakan adanya korelasi lemah antara pertambahan usia dengan ketebalan septum interalveolar.

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As age goes by, changes in intrapulmonary condition may result in respiratory disorders. This research aims to find correlation between interalveolar septal thickness and age. Research method used in this study was laboratorim-based study with cross sectional design. As a subject used in this study, Sprague dawley rat sorted in age-related order : 2 days group, 16 days group, 3-4 months group, more than 12 months group. In accordance with the age-related grouping, alveolar tissue sampling was done and stained by trichrome-masson staining method. Measurement was done by comparing interalveolar septal thickness with microscope field of view. Result data normality evaluated by Shapiro-wilk test then tested with Pearson correlation test. Calculation of mean alveolar wall thickness value from each age-related groups gives following results: 2-days group: 0.436 ± 0.059 m thick, while 16-days group: 0.399 ± 0.022 m thick, 3-4 months old group: 0.474 ± 0.043 m thick, and >12 months old group: 0.512 ± 0.020 m thick. Pearson correlation test gave result of r=0,375 which marked a weak correlation between age and interalveolar septum thickness."