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Dogma Handal
Karakteristik kaki diabetik di hubungkan dengan penilaian "PEDIS" yang dilakukan Débridement di Divisi Bedah Vaskular RSUPN Dr. Cipto Mangunkusumo = Characteristic of diabetic foot in association with "PEDIS" assessment as do Débridement in the Division Vascular Surgery RSUPN Dr. Cipto Mangunkusumo
"[ABSTRAK
Pendahuluan: Kaki diabetik (KD) merupakan salah satu komplikasi kronik dari Diabetes Mellitus (DM), karena sering berujung pada kecacatan karena tingginya angka amputasi dan bahkan kematian. WHO merekomendasikan klasifikasi Perfusion, Extent/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) sebagai sarana penegakkan diagnosis dan membantu menentukan tatalaksana KD. Pada beberapa studi yang menggunakan klasifikasi PEDIS dapat memprediksi perlunya perawatan kasus KD di RS dan perkiraan angka amputasi yang hanya di tinjau dari aspek Infection saja. Namun hubungan kriteria PEDIS secara keseluruhan yang dapat memengaruhi outcome belum diketahui. Atas dasar itu perlu dilakukan penelitian untuk mengetahui gambaran KD berdasarkan penilaian PEDIS yang dilakukan tindakan débridement. Metode penelitian: Kohort retrospektif. Hasil penelitian: Didapatkan hubungan bermakna kriteria PEDIS dengan sembuh tidak diamputasi; Perfusi derajat 1 [OR=38,46; p<0,05]. Perfusi derajat 2 [OR=26,86; p<0,05]. Depth derajat 1 [OR=107,25; p<0,05]. Depth derajat 2 [OR=20,20; p<0,05]. Infeksi derajat 2 [OR=18,00; p<0,05]. Infeksi derajat 3 [OR=2,67; p<0,05]. Didapatkan juga hubungan bermakna kriteria PEDIS dengan sembuh diamputasi; Perfusi derajat 3 [OR=0,03; p<0,05]. Depth derajat 3 [OR=0,01; p<0,05]. Dari kategori sensasi [OR=0,29; p<0,05]. Rerata lama rawat subkategori infeksi derajat 1,2,3 dan 4 bermakna (p<0,05). Kesimpulan: Semakin tingginya tingkat keparahan atau derajat dari setiap subkategori kriteria PEDIS, secara statistik bermakna kecenderungan ke arah meningkatnya risiko buruknya outcome. ABSTRACT Background: Diabetic foot (DF) is one of the chronic complications of Diabetes Mellitus (DM). It often lead to disability due to the high number of amputations and even ended in mortality. WHO recommended classification of Perfusion, Extent / Size, Depth / Tissue Loss, Infection, Sensation (PEDIS) as the means of diagnosis and to help determine the treatment of DF. In some studies using PEDIS classification could predict the need for hospital care in cases of diabetic foot and predict the rate of amputations in review to Infection aspect only. However, the overall relationship PEDIS criteria that could influence the outcome is not yet known. Based on that, it is necessary to study the distribution of DF based on PEDIS assessment which undergone debridement. Method: Retrospective cohort. Results: In this study we found a significant association of PEDIS criteria toward the patients outcome recover without amputation with; Perfusion grade 1 [OR=38,46; p<0,05]. Perfusion grade 2 [OR=26,86; p<0,05]. Depth grade 1 [OR=107,25; p<0,05]. Depth grade 2 [OR=20,20; p<0,05]. Infection grade 2 [OR=18,00; p<0,05]. Infection grade 3 [OR=2,67; p<0,05]. The others found a significant associated PEDIS criteria toward the patients outcome were cured in amputation is; Perfusion grade 3 [OR=0,03; p<0,05]. Depth grade 3 [OR=0,01; p<0,05]. From sensation category [OR=0,29; p<0,05]. There are significant differences in the average length of stay of patients from infection subcategories grade 1, 2, 3 and 4 (p<0,05). Conclusions: With increasing of severity or grade of each subcategory of PEDIS criteria, there was a statistically significant trend toward increased risk for adverse outcome.;Background: Diabetic foot (DF) is one of the chronic complications of Diabetes Mellitus (DM). It often lead to disability due to the high number of amputations and even ended in mortality. WHO recommended classification of Perfusion, Extent / Size, Depth / Tissue Loss, Infection, Sensation (PEDIS) as the means of diagnosis and to help determine the treatment of DF. In some studies using PEDIS classification could predict the need for hospital care in cases of diabetic foot and predict the rate of amputations in review to Infection aspect only. However, the overall relationship PEDIS criteria that could influence the outcome is not yet known. Based on that, it is necessary to study the distribution of DF based on PEDIS assessment which undergone debridement. Method: Retrospective cohort. Results: In this study we found a significant association of PEDIS criteria toward the patients outcome recover without amputation with; Perfusion grade 1 [OR=38,46; p<0,05]. Perfusion grade 2 [OR=26,86; p<0,05]. Depth grade 1 [OR=107,25; p<0,05]. Depth grade 2 [OR=20,20; p<0,05]. Infection grade 2 [OR=18,00; p<0,05]. Infection grade 3 [OR=2,67; p<0,05]. The others found a significant associated PEDIS criteria toward the patients outcome were cured in amputation is; Perfusion grade 3 [OR=0,03; p<0,05]. Depth grade 3 [OR=0,01; p<0,05]. From sensation category [OR=0,29; p<0,05]. There are significant differences in the average length of stay of patients from infection subcategories grade 1, 2, 3 and 4 (p<0,05). Conclusions: With increasing of severity or grade of each subcategory of PEDIS criteria, there was a statistically significant trend toward increased risk for adverse outcome., Background: Diabetic foot (DF) is one of the chronic complications of Diabetes Mellitus (DM). It often lead to disability due to the high number of amputations and even ended in mortality. WHO recommended classification of Perfusion, Extent / Size, Depth / Tissue Loss, Infection, Sensation (PEDIS) as the means of diagnosis and to help determine the treatment of DF. In some studies using PEDIS classification could predict the need for hospital care in cases of diabetic foot and predict the rate of amputations in review to Infection aspect only. However, the overall relationship PEDIS criteria that could influence the outcome is not yet known. Based on that, it is necessary to study the distribution of DF based on PEDIS assessment which undergone debridement. Method: Retrospective cohort. Results: In this study we found a significant association of PEDIS criteria toward the patients outcome recover without amputation with; Perfusion grade 1 [OR=38,46; p<0,05]. Perfusion grade 2 [OR=26,86; p<0,05]. Depth grade 1 [OR=107,25; p<0,05]. Depth grade 2 [OR=20,20; p<0,05]. Infection grade 2 [OR=18,00; p<0,05]. Infection grade 3 [OR=2,67; p<0,05]. The others found a significant associated PEDIS criteria toward the patients outcome were cured in amputation is; Perfusion grade 3 [OR=0,03; p<0,05]. Depth grade 3 [OR=0,01; p<0,05]. From sensation category [OR=0,29; p<0,05]. There are significant differences in the average length of stay of patients from infection subcategories grade 1, 2, 3 and 4 (p<0,05). Conclusions: With increasing of severity or grade of each subcategory of PEDIS criteria, there was a statistically significant trend toward increased risk for adverse outcome.]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Dogma Handal
Kualitas hidup pasien pascaesofagektomi dan faktor-faktor yang berhubungan di RSUPN Dr. Cipto Mangunkusumo = Quality of life and its associated factors in patients after esophagectomy at a single national referral center
"Pendahuluan. Esofagektomi merupakan tata laksana pembedahan standar bagi pasien kanker esofagus resektabel. Namun, angka kesembuhan tindakan ini hanya berkisar antara 25 - 35% dan dihubungkan dengan seriusnya risiko komplikasi pascabedah. Pasien pascaesofagektomi diketahui mengalami penurunan kualitas hidup, tetapi belum ada penelitiannya di Indonesia. Penelitian ini dilakukan untuk mengetahui kualitas hidup pasien pascaesofagektomi pada populasi pasien di RSUPN Dr. Cipto Mangunkusumo (RSCM).
Metode. Penelitian ini merupakan kohort retrospektif dengan menggunakan instrumen yang dikeluarkan oleh European Organization for Research and Treatment of Cancer (EORTC), yaitu modul khusus kanker esofagus EORTC-QLQ-OES18 dan core questionnaire C30. Populasinya adalah pasien pascaesofagektomi periode 2015—2021 di RSCM.
Hasil. Sebanyak 35 subjek dilakukan esofagektomi dan rekonstruksi pascaesofagektomi. Terdiri dari laki-laki 62,9% dan perempuan 37,1%. Rerata usia adalah 43,8 tahun (SB: 13,1). Median kualitas hidup (global health) dari semua subjek adalah 83,3 (IQR: 25,0). Item pertanyaan skala fungsional terhadap keseluruhan subjek yang memiliki skor paling rendah adalah cognitive functioning (CF). Sedangkan berdasarkan item pertanyaan skala gejala terhadap keseluruhan subjek yang memiliki skor paling tinggi, yaitu nausea and vomiting (NV), pain (PA), dysphagia (OESDYS), eating (OESEAT), choking (OESCH), dan coughing (OESCO).
Kesimpulan. Kualitas hidup pasien pascaesofagektomi di RSCM berdasarkan kuesioner EORTC-QLQ-C30 dan OES18 secara keseluruhan tergolong baik. Faktor prognostik yang berhubungan dengan penurunan kualitas hidup sebaiknya lebih diedukasi ke pasien dan dilakukan upaya persiapan sejak sebelum tindakan esofagektomi dikerjakan sehingga dapat memaksimalkan kualitas hidup pascaoperasi.
Introduction. Esophagectomy is the standard surgical treatment for resectable esophageal cancer patients. However, the success rate for this procedure was about 25—35% and was associated with a severe risk of postoperative complications. Patients after esophagectomy have decreased their quality of life (QOL), but no research has been done in Indonesia. This study was conducted to determine the quality of life after esophagectomy in Indonesia based on the patient population at Dr. Cipto Mangunkusumo General Hospital (CMGH).
Method. A retrospective study was conducted using quality of life instruments issued by the European Organization for Research and Treatment of Cancer (EORTC). It consists of the module for esophageal cancer EORTC-QLQ-OES18 and the core questionnaire C30. Subjects were patients after esophagectomy in 2015—2021 at CMGH.
Results. About 35 subjects underwent esophagectomy and followed by reconstruction, which comprised 62.9% male and 37.1% female. The mean age was 43.8 years (SD: 13.1 years). All subjects' median global health was 83.3 (IQR: 25.0). The overall functional scale question item with the lowest score was cognitive functioning (CF) 66.7 (IQR: 50.0). Meanwhile, based on the question items on the overall symptom scale, the worst scores were nausea and vomiting (NV) 16.7 (IQR: 50.0), pain (PA) 16.7 (IQR: 33.3), dysphagia (OESDYS) 33.3 (IQR: 33.3), eating (OESEAT) 34.5 (IQR: 23.9), choking (OESCH) 33.3 (IQR: 33.3), and coughing (OESCO) 33.3 (IQR: 33.3).
Conclusion. The overall QOL after esophagectomy at CMGH based on the EORTC-QLQ-C30 and OES18 questionnaires was good. Prognostic factors associated with decreased quality of life should be better educated to patients and prepared well before the esophagectomy procedure, thus maximizing quality of life after esophagectomy.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library