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"[ABSTRAKLatar Belakang : Kejadian mortalitas dan MACE merupakan komplikasi pasca PCI yang seringkali terjadi. Kemampuan ahli dalam memprediksi komplikasi dengan cara melakukan stratifikasi risiko menggunakan skor risiko. New Mayo Clinic Risk Score (NMCRS) menggunakan tujuh variabel yang mudah didapatkan pada data awal pasien dan memiliki performa yang baik. Belum ada studi untuk karakteristik mortalitas dan MACE pada NMCRS di ICCU RSCM.Tujuan : mengetahui insidens mortalitas dan MACE serta karakteristik NMCRS pada pasien pasca PCI selama perawatan di ICCU RSCM.Metode : Penelitian dengan desain kohort retrospektif terhadap 313 pasien SKA pasca PCI di ICCU RSCM, dalam kurun waktu 1 Agustus 2013? 31 Agustus 2014. Data pasien dari rekam medis dimasukkan ke dalam tujuh variabel skor NMCRS kemudian ditentukan hasil setiap kategori risiko.Hasil : Insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Pasien-pasien dengan usia yang semakin tua, fraksi ejeksi ventrikel kiri yang rendah, infark miokard, kreatinin serum yang meningkat, adanya syok kardiogenik pra prosedur, dan adanya penyakit arteri perifer memiliki kejadian mortalitas dan MACE yang lebih tinggi pasca PCI. Skor NMCRS untuk mortalitas menunjukkan kategori risiko sangat rendah 167 pasien (53%), risiko rendah 60 pasien (19%), sedang 47 pasien (15%), tinggi 10 pasien (3%) dan risiko sangat tinggi 29 pasien (9%). Kejadian mortalitas pada kategori risiko sangat rendah 2 kasus (1,2%), rendah 0 pasien, sedang 2 pasien (4,25%), tinggi 1 pasien (10%) dan sangat tinggi 7 kasus (24,13%). Skor NMCRS untuk MACE memberikan hasil kategori sangat rendah 101 pasien (32%), risiko rendah 128 pasien (41%), sedang 52 pasien (17%), tinggi 16 pasien (5%) dan sangat tinggi 16 kasus (5%). Kejadian MACE untuk risiko sangat rendah sebanyak 4 kasus (3,96%), rendah 7 pasien (5,46%), sedang 4 pasien (7,69%), tinggi 5 pasien (31,25%) dan risiko sangat tinggi 6 kasus (37,5%).Kesimpulan : insidens mortalitas pasien pasca PCI selama perawatan 3,8% (IK 95% 2,6;5) dan MACE pasca PCI selama perawatan 8,3% (IK 95% 6,6;10). Kenaikan skor NMCRS maka akan diiringi peningkatan kejadian mortalitas dan MACE pasca PCI.

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ABSTRACTBackground : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.;Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI., Background : Mortality and MACE was an often complication post PCI. Capability from an expert in predict complication by doing risk stratification using risk score. New Mayo Clinic Risk Score (NMCRS) using seven variables easy to collect from medical record and had a good performance. No report about mortality and MACE studies NMCRS characteristic for post PCI patients in ICCU RSCM.Objective : To obtain mortality and MACE incidence and also NMCRS characteristic on post PCI patients in ICCU RSCM.Methods : A retrospective cohort study was conducted to evaluate 313 post PCI patients in ICCU RSCM between August 1st 2013 and August 31 2014. Patients data from medical records collect for seven variables and determined category results for each risk category.Results : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and inhospital MACE post PCI 8,3% (CI 95% 6,6-10). Patients that getting older, lower left ventricular ejection fraction, increase serum creatinine, pre-procedure cardiogenic shock, myocardial infarct and peripheral arterial disease had higher mortality and MACE post PCI. NMCRS in predict risk of mortalitas shown for very low risk 167 patient (53%), low risk 60 patient (19%), moderate risk 47 patient (15%), high risk 10 patient (3%) and very high risk 29 patient (9%). Mortality in very low risk 2 patient (1,2%), low risk no patient, moderate 2 patient (4,25%), high 1 patient (10%) and very high risk 7 patient (24,13%). NMCRS in predict MACE shown for very low risk 101 patient (32%), low risk 128 patient (41%), moderate 52 patient (17%), high 16 patient (5%) very high risk 16 patient (5%). MACE in very low risk 4 patient (3,96%), low risk 7 patient (5,46%), moderate risk 4 patient (7,69%), high risk 5 patient (31,25%) and very high risk 6 patient (37,5%).Conclusion : In-hospital mortality post PCI incidence 3,8% (CI 95% 2,6;5) and in-hospital MACE post PCI incidence 8,3% (CI 95% 6,6;10). The increase of NMCRS score was also followed with the increase of mortality and MACE post PCI.]"

"Latar Belakang: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) adalah masalah besar yang mengancam Indonesia dan banyak negara di seluruh dunia. Pengetahuan tentang karakteristik dan prediktor mortalitas dapat membantu dalam penatalaksanaan pasien. Penelitian terdahulu mengenai faktor-faktor prediktor mortalitas di Indonesia belum ada. Tujuan: Mengetahui faktor-faktor prediktor mortalitas pasien HIV/AIDS dewasa yang dirawat inap di Rumah Sakit Cipto Mangunkusumo (RSCM). Metode: Penelitian ini merupakan studi kohort retrospektif pada pasien rawat inap dewasa RSCM yang didiagnosis HIV/AIDS selama tahun 2011-2013. Data klinis dan laboratorium beserta status luaran (meninggal atau hidup) dan penyebab mortalitas selama perawatan diperoleh dari rekam medis. Analisis bivariat menggunakan uji Chi-Square dilakukan pada tujuh variabel prognostik, yaitu jenis kelamin laki-laki, tidak dari rumah sakit rujukan, tidak pernah/putus terapi antiretroviral (ARV), stadium klinis WHO IV, kadar hemoglobin <10 g/dL, kadar eGFR <60 mL/min/1,73 m2 dan kadar CD4+ ≤200 sel/µL. Variabel yang memenuhi syarat akan disertakan pada analisis multivariat dengan regresi logistik. Hasil: Dari 606 pasien HIV/AIDS dewasa yang dirawat inap (median usia 32 tahun; laki-laki 64,2%), sebanyak 122 (20,1%) baru terdiagnosis HIV selama rawat dan 251 (41,5%) dalam terapi ARV. Median lama rawat adalah 11 (rentang 2 sampai 75) hari. Sebanyak 425 (70,1%) pasien dirawat karena infeksi oportunistik. Mortalitas selama perawatan sebesar 23,4% dengan mayoritas (92,3%) penyebabnya terkait AIDS. Prediktor independen mortalitas yang bermakna adalah stadium klinis WHO IV (OR=6,440; IK 95% 3,701 sampai 11,203), kadar hemoglobin <10 g/dL (OR=1,542; IK 95% 1,015 sampai 2,343) dan kadar eGFR <60 mL/min/1,73 m2 (OR=3,414; IK 95% 1,821 sampai 6,402). Simpulan: Proporsi mortalitas selama perawatan sebesar 23,4%. Stadium klinis WHO IV, kadar hemoglobin <10 g/dL dan kadar eGFR <60 mL/min/1,73 m2 merupakan prediktor independen mortalitas pasien HIV/AIDS dewasa saat rawat inap.

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Background: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is a big problem that threatening in Indonesia and many countries in the world. The knowledge on the characteristics and prediction of outcome were important for patients management. There are no studies on the predictors of mortality in Indonesia.

Objective: To determine the predictors of mortality in hospitalized adult patients with HIV/AIDS in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Methods: We performed a retrospective cohort study among hospitalized adult patients with HIV/AIDS in Cipto Mangunkusumo Hospital between 2011-2013. Data on clinical, laboratory, outcome (mortality) and causes of death during hospitalization were gathered from medical records. Bivariate analysis using Chi- Square test were used on the seven prognostic factors (male sex, not came from referral hospital, never/ever received antiretroviral therapy (ART), WHO clinical stage IV, hemoglobin level <10 g/dL, eGFR level <60 mL/min/1.73 m2 and CD4+ count ≤200 cell/µL). Multivariate logistic regression analysis was performed to identify independent predictors of mortality.

Results: Among 606 hospitalized HIV/AIDS patients (median age 32 years; 64.2% males), 122 (20.1%) were newly diagnosed with HIV infection during the hospitalization and 251 (41.5%) on ART. Median length of stay was 11 (range 2 to 75) days. There were 425 (70.1%) patients being hospitalized due to opportunistic infection. In-hospital mortality rate was 23.4% with majority (92.3%) due to AIDS-related illnesses. The independent predictors of mortality in multivariate analysis were WHO clinical stage IV (OR=6.440; 95% CI 3.701 to 11.203), hemoglobin level <10 g/dL (OR=1.542; 95% CI 1.015 to 2.343) and eGFR level <60 mL/min/1.73 m2 (OR=3.414; 95% CI 1.821 to 6.402).

Conclusions: In-hospital mortality rate was 23.4%. WHO clinical stage IV, hemoglobin level <10 g/dL and eGFR level <60 mL/min/1.73 m² were the independent predictors of in-hospital mortality among hospitalized patients with HIV/AIDS."