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Abstrak :
Latar belakang: Hemofilia merupakan gangguan perdarahan yang bersifat herediter yang disebabkan oleh kekurangan faktor VIII. Pada kadar faktor koagulasi yang sama dapat menunjukkan karakteristik klinis yang berbeda. Tujuan: Mengidentifikasi karakteristik klinis, penggunaan faktor VIII, dan komplikasi pada anak hemofilia A. Metode: Penelitian kohort retrospektif pada anak le;18 tahun. Data diambil dari rekam medis Januari 2014 ndash; Juni 2016 meliputi data usia awitan perdarahan sendi, usia saat didiagnosis, kekerapan perdarahan, lokasi perdarahan, penggunaan faktor VIII, dan komplikasi yang dialami. Hasil: Terdapat 109 subjek anak lelaki terdiri dari 2,8 subjek hemofilia A ringan, 27,5 hemofilia A sedang, dan 69,7 hemofilia A berat. Perdarahan paling sering ditemukan pada sendi 60,6 terutama pada lutut 37,2 . Anak hemofilia A berat menunjukkan usia awitan perdarahan sendi yang lebih dini median 12,5 4 - 120 bulan , kekerapan perdarahan sendi yang lebih sering median 8 1-44 kali/tahun , menggunakan konsentrat faktor VIII yang lebih banyak median 712 131 - 1913 IU/kg/tahun . Komplikasi yang ditemukan adalah hemofilik artropati dan sinovitis 46,8 , terbentuknya inhibitor faktor VIII 7,3 , anemia akibat perdarahan 2,6 , pseudotumor 0,9 , dan fraktur 0,9 . Terdapat 15,5 subjek hemofilia A berat yang menunjukkan karakteristik klinis yang lebih ringan. Simpulan: Usia awitan perdarahan sendi berhubungan dengan kekerapan perdarahan sendi, kebutuhan faktor VIII, dan artropati. Artropati dan sinovitis merupakan komplikasi yang paling banyak ditemukan. ......Background: Hemophilia A is a congenital bleeding disorder caused by deficiency of factor VIII. Phenotypic differences between patients with hemophilia is well known from clinical practice. Aim: To identify clinical characteristics, factor VIII usage for on demand therapy, and complications of children with hemophilia A. Method: A retrospective cohort study on children aged le 18 years. Data was obtained from medical record January 2014 ndash June 2016 including age of diagnosis, age of first joint bleed, number of bleeding, site of bleeding, treatment requirement, and complications. Result: We found a total of 109 boys with hemophilia A consisted of 2.8 mild, 27.5 moderate, and 69.7 severe hemophilia. The most common bleeding was hemarthrosis 60.6 of the knee 37.2 . Severe hemophilia children showed earlier age of first joint bleed median 12,5 4 to 120 months , higher number of joint bleeds median 8 1 44 times year , and higher consumptions of clotting factor median 712 131 to 1913 IU kg year compared to mild and moderate hemophilia. Complications commonly found in severe hemophilia were haemophilic arthropathy and sinovitis 46.8 , followed by factor VIII inhibitors 7.3 , anaemia due to bleeding 2.6 , pseudotumour 0.9 , and fracture 0.9 . This study showed that 15.5 of patients with severe hemophilia A have mild clinical characteristics. Conclusion: The onset of joint bleeding is related with number of joint bleeds, treatment requirement, and arthropathy and may serve as an indicator of clinical phenotype.

Abstrak :
Osteogenesis imperfekta (OI) merupakan adalah penyakit genetik kelainan jaringan ikat berupa kerapuhan tulang dan fraktur berulang tanpa adanya trauma yang signifikan. Terdapat berbagai karakteristik klinis yang khas untuk mendiagnosis OI. Terapi bisfosfonat merupakan terapi utama pada OI yang bermanfaat untuk menurunkan insiden patah tulang agar tercapai kualitas hidup yang lebih baik. Penelitian ini bertujuan mengetahui karakteristik klinis dan luaran terapi bisfosfonat pada pasien anak dengan OI di RSCM. Penelitian ini dilakukan secara potong lintang terhadap 71 pasien OI berusia 0-18 tahun di RSCM pada 16-22 November 2020. Data diambil melalui kuesioner daring yang diisi oleh orangtua atau wali. Karakteristik klinis OI mencakup sklera biru (83%) dan patah tulang pada 69 (97%) pasien dengan lokasi paling banyak di tulang femur (66,2%). Hanya terdapat 18 subyek yang sudah melakukan pemeriksaan pendengaran dengan 4 (22%) diantaranya terdapat gangguan pendengaran. Klasifikasi klinis OI paling banyak adalah tipe berat (57%). Enam puluh lima subyek mengalami patahtulang di usia kurang dari 6 tahun termasuk intrauterin dan perinatal. Sebanyak 95,8% subyek mendapatkan terapi bisfosfonat dan hampir seluruhnya diberikan rutin setiap 6 bulan. Terdapat penurunan median kejadian patah tulang sebelum terapi bisfosfonat sebanyak 3,5 kejadian/tahun menjadi satu kejadian/tahun setelah terapi bisfosfonat. Terapi bisfosfonat dapat menurunkan angka kejadian patah tulang setiap tahun. ......Osteogenesis imperfecta (OI) is a genetic disorder of connective tissue causing bone fragility and fractures in the absence of significant trauma. There are many typical clinical features of OI. Bisphosphonate therapy is the main therapy which significantly decreases fracture rate for better quality of life. This study was aimed to observe the clinical features and outcomes of bisphosphonate therapy in pediatric OI patients. A cross sectional study was conducted at Cipto Mangunkusumo Hospital (CMH) in the period of November 16th-22nd 2020. There were 71 patients aged 0-18 years old included for study analysis. Data were obtained from online questionnaire which was filled by their parents or guardians. The clinical features observed were blue sclera (83%) and fractures which occurred in 69 (97%) patients with the most common location was femur (66.2%). There were only 18 patients who underwent hearing examination and 4 of them (22%) had hearing problem. Most patients had severe OI classification (57%). Sixty-five patients had first fracture when their age <6 years old, including intrauterine and perinatal fractures. A total of 95.8% patients had received bisphosphonate therapy and almost all of patients had received treatment every 6 month. There was a decrease in the number of fractures from 3.5 events/year (before bisphosphonate therapy) to 1 event/year after bisphosphonate therapy. The outcome of bisphosphonate therapy was significant in terms of fracture incidence reduction. Bisphosphonate therapy was able to reduce fracture incidence per year.

Abstrak :
Seluruh aspek kehidupan telah dipengaruhi oleh pandemi COVID-19 termasuk bidang kesehatan. Disisi lain, terdapat peningkatan jumlah penderita kanker setiap tahunannya. Hubungan karakteristik klinis kanker ginekologi dengan infeksi COVID-19 terhadap mortalitas belum banyak diteliti. Dalam penelitian ini digunakan metode retrospective cross-sectional yang menggunakan data pasien penderita kanker ginekologi dengan infeksi COVID-19 yang terdaftar pada Departemen Obstetri Ginekologi RSPUN Dr. Cipto Mangunkusumo pada tahun 2020-2022. Penelitian ini menggunakan analisis uji Chi Square untuk menentukan variable yang akan dimasukan kedalam analisis regresi logistik backward stepwise. Dalam penelitian ini ditemukan usia >59 (OR, 0.020; Cl 95% 0.001-0.577; P= 0.023), anemia(OR,0.053; Cl 95% 0.005-0.565; P= 0.015), ARDS (OR, 50,010; CL 95%, 1,145-2185.101; P = 0.042), Hyperkalemia (OR, 11,189; Cl 95% 1,491-83.992; P = 0.019), Sepsis (OR, 18,386; Cl 95% 2,220-152.253; P= 0.007), ECOG >2 (OR, 12.859; Cl 95% 2.582-64.020; P= 0.002), and Degree of Severe-Critical COVID-19 (OR, 111.310; Cl 95% 3.961-3128.117; P= 0.006). Dapat disimpulkan ARDS, hyperkalemia, sepsis, ECOG >2, dan derajat COVID-19 berat-kritis memiliki signifikansi baik terhadap statistik maupun klinis dengan mortalitas, namun usia > 59 dan anemia secara klinis tidak memiliki signifikansi. ...... All aspects of life have been affected by the COVID-19 pandemic, including the health sector. On the other hand, the number of cancer patients is continuously increasing every year. The relationship between clinical characteristics of gynecological cancer with COVID-19 infection and mortality has not been widely studied. This study used a retrospective cross-sectional method using data on patients with gynecological cancer with COVID-19 infection registered in the gynecology department of Dr. Cipto Mangunkusumo Hospital in 2020-2022. This study used chi-squared test analysis to determine the variables to be included in backward stepwise logistic regression analysis. In this study, it was found that age >59 (OR, 0.020; Cl 95% 0.001-0.577; P = 0.023), anemia (OR, 0.020; Cl 95% 0.001-0.578; p= 0.023), ARDS (OR, 48.796;  Cl 95%, 1.131-2105.921; P=0.043), hyperkalemia (OR, 10.960; Cl 95% 1.462-82.187; p= 0.020), sepsis (OR, 18.087; Cl 95% 2.192-149.271; P= 0.007), ECOG >2 (OR, 12.629; Cl 95% 2.538-62.854; P= 0.002), and degree of severe-critical COVID-19 (OR, 108.771; Cl 95% 3.917-3020.095; P= 0.006). It can be concluded that ARDS, hyperkalemia, sepsis, ECOG >2 and degree of severe-critical COVID-19 have both statistical and clinical significance with mortality, but age >59 and anemia have no clinical significance.

Abstrak :
Latar belakang: Pasien tuberkulosis (TB) paru rentan mengalami infeksi oportunistik, termasuk oleh Aspergillus (aspergilosis paru). Keberadaan Aspergillus dikonfirmasi dengan uji kultur. Uji kepekaan Aspergillus terhadap obat anti-jamur (OAJ) dilakukan untuk mengetahui pilihan OAJ yang tepat. Itrakonazol merupakan salah satu OAJ pilihan untuk aspergilosis paru. Resistensi OAJ dapat disertai gejala klinis yang luas. Penelitian ini bertujuan untuk mengetahui karakteristik klinis pasien dikaitkan dengan hasil uji kepekaan Aspergillus terhadap itrakonazol. Metode: Penelitian potong-lintang ini dilakukan pada Juli-November 2021 dan merupakan bagian dari penelitian sebelumnya. Isolasi Aspergillus dari sputum pasien TB paru dilakukan menggunakan medium agar Sabouraud. Karakteristik klinis yang diteliti meliputi usia, jenis kelamin, indeks massa tubuh (IMT), dan gejala. Adapun uji kepekaan jamur dilakukan dengan metode cakram sesuai protokol. Hasil: Penelitian ini menyertakan 28 isolat Aspergillus sp. yang berasal dari sputum 28 pasien TB paru. Jumlah pasien laki-laki lebih dominan (24 orang). Rerata usia 50 ± 15,1 tahun, dengan kelompok usia terbanyak < 60 tahun (21 pasien). Sebanyak 12 pasien (42,9%) memiliki IMT rendah. Gejala klinis yang didapatkan meliputi: batuk (42,9%), batuk darah (35,7%), sesak (39,3%), nyeri dada (14,3%), dan rasa lelah (35,7%). Kultur sputum menunjukkan pertumbuhan 28 isolat Aspergillus, terdiri atas: 14 isolat Aspergillus fumigatus, 6 isolat Aspergillus flavus, dan 8 isolat Aspergillus niger. Uji kepekaan Aspergillus terhadap itrakonazol menunjukkan 23 isolat sensitif, 3 isolat intermediat, dan 2 isolat resisten. Analisis statistik menunjukkan tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan jamur. Kesimpulan: Tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan Aspergillus terhadap itrakonazol dalam penelitian ini. ......Introduction: Pulmonary tuberculosis (TB) patients are susceptible to opportunistic infections, including Aspergillus infections (aspergillosis). The presence of Aspergillus was confirmed by a culture test, followed by its susceptibility study to antifungal. Antifungal resistance is generally accompanied by serious symptoms, so clinical observations are important for better clinical awareness. This study aims to determine the relationship between clinical characteristics and susceptibility study of Aspergillus to itraconazole. Method: This cross-sectional study was carried out from July-November 2021, as part of the previous study on aspergillosis in TB patients. Aspergillus was isolated from the sputum of pulmonary TB patients using Saboraud's agar dextrose medium. Clinical characteristics obtained through patient’s history including age, gender, body mass index, and symptoms The fungal susceptibility test was carried out by disc diffusion method according to the protocol after treatment. Result: This study included 28 isolates of Aspergillus from the sputum of 28 pulmonary TB patients. The number of males were dominant (24 from 28 patients) than females. The mean age was 50 ± 15.1 years, with the commonest age group < 60 years (21 patients). Total of 12 patients (42.9%) had a low body mass index. Clinical symptoms included: cough (42.9%), hemoptysis (35.7%), dyspnea (39.3%), chest pain (14.3%), and fatigue (35.7%). %). The sputum culture showed 14 Aspergillus fumigatus isolates, 6 Aspergillus flavus isolates, and 8 Aspergillus niger. The susceptibility test of Aspergillus to itraconazole revealed 23 sensitive isolates, 3 intermediate isolates, and 2 resistant isolates. Statistical analysis showed that there was no relationship between the patient’s clinical characteristics and the antifungal susceptibility test of itraconazole. Conclusion: There was no significant correlation between the patient’s clinical characteristics and the antifungal susceptibility test to itraconazole in this study

Abstrak :
Latar Belakang. Sejak laporan pertama ensefalitis antireseptor N-methyl-D-aspartate (NMDA) pada 2007, prevalensi ensefalitis autoimun (EA) serupa dengan ensefalitis infeksi (EI). Sayangnya, heterogenitas klinis EA, serupanya klinis dengan EI, penyakit autoimun seperti neuropsikiatrik lupus eritematosus sistemik, atau penyakit psikiatrik menjadi tantangan deteksi awal dan tatalaksana EA. Keterlambatan berhubungan dengan perburukan luaran, sedangkan kekurang-tepatan menerapi EI sebagai EA dapat mengeksaserbasi infeksi. Studi ini bertujuan mengenali karakteristik EA, khususnya ensefalitis antireseptor NMDA definit sebagai EA tersering, di era keterbatasan ketersediaan penunjang definitif di Indonesia. Metode. Studi kohort retrospektif dengan rekam medis di RSUPN dr. Cipto Mangunkusumo dilakukan pada curiga EA yang menjalani pemeriksaan antireseptor NMDA cairan otak sejak Januari 2015-November 2022. Karakteristik klinis dan penunjang EA, EA seropositif NMDA, dan luarannya dinilai. Analisis univariat dan bivariat dilakukan sesuai kebutuhan. Hasil. Dari 102 subjek yang melalui kriteria inklusi dan eksklusi, terdapat 14 EA seropositif dan 32 seronegatif NMDA. Temuan klinis EA terbanyak adalah gangguan psikiatri dan tidur (85,7%), gangguan kesadaran (78,3%), prodromal (76,1%), dan bangkitan (70,6%). Karakteristik penunjang EA adalah inflamasi sistemik (75,0%), inflamasi cairan otak (69,2%), abnormalitas MRI (57,9%) dominan inflamasi (42,2%), dan abnormalitas EEG (89,5%). Karakteristik klinis EA seropositif NMDA adalah psikosis (76,9% vs 24,1%, p=0,002), delirium (71,4% vs 40,6%, p=0,06), bangkitan (71,4% vs 46,7%, p=0,12), takikardia (55,6% vs 17,6%, p=0,08), dan gangguan otonom lainnya (55,6% vs 23,5%, p=0,19), sedangkan klinis EA seronegatif NMDA adalah somnolen (34,4% vs 7,1%, p=0,07) dan defisit neurologis fokal (31,3% vs 7,1%, p=0,13). Leukositosis dan pleositosis cairan otak dengan dominasi mononuklear secara signifikan lebih ditemukan pada EA seropositif NMDA. Sebanyak 10,9% subjek meninggal. Kesimpulan. Karakteristik klinis EA adalah gangguan psikiatri dan tidur, gangguan kesadaran, prodromal, dan bangkitan. Psikosis, delirium, bangkitan, dan disfungsi otonom cenderung lebih ditemukan pada EA seropositif NMDA. Inflamasi sistemik, cairan otak, MRI, dan abnormalitas EEG sering ditemukan pada EA, terutama seropositif NMDA.  ......Background. Since the first report of N-methyl-D-aspartate receptor (NMDAR) encephalitis in 2007, the prevalence of autoimmune encephalitis (AE) was similar to infectious encephalitis (IE). Unfortunately, heterogenities of EA as well as similarities in the manifestation to IE, other autoimmune diseases including neuropsychiatric systemic lupus erythematosus, or psychiatric diseases compromised the early detection and management of EA. This delay correlated with worse outcome whereas the inaccuracy in treting IE as AE may exacerbate infection. This study aimed to describe the characteristics of EA, particularly definitive NMDAR encephalitis as the most common, in the era of limited availability of definitive ancillary test in Indonesia. Methods. Retrospective study using medical records at Dr. Cipto Mangunkusumo National Center General Hospital was conducted for suspected EA cases tested for cerebrospinal fluid NMDAR autoantibody test from January 2015 to November 2022. Clinical, ancillary characteristics, and concordance between clinical diagnosis and diagnostic criteria were assessed. Univariate, bivariate, and multivariate analysis were perfomed as needed. Result. Of 102 subjects following inclusion and exclusion criteria, there were 14 seropositive and 32 seronegative NMDA subject. Clinical characterstics of AE were psychiatric and sleep disorder (85,7%), altered consciousness (78.3%), prodromal (76.1%), and seizure (70.6%). Ancillary characteristics of AE were systemic inflammation (75.0%), cerebrospinal fluid inflammation (69.2%), MRI abnormalities (57.9%) with inflammatory predominance (42.2%), and EEG abnormalities (89.5%). Seropositive NMDA characteristics were psychosis (76.9% vs 24.1%, p=0.002), delirium (71.4% vs 40.6%, p=0.06), seizure (71.4% vs 46.7%, p=0.12), tachycardia 955.6% vs 17.6%, p=-0.08), and other autonomic disorder (55.6% vs 23.5% p=0.19) whereas seronegative NMDA characteristics were somnolence (34.4% vs 7.1%, p=0.07) and focal neurologic deficit (31.3% vs 7.1%, p=0.13). Leukocytosis and cerebrospinal fluid pleocytosis with mononuclear predominance were significantly found in seropositive NMDA AE. The mortality rate was 10.9%. Conclusion. Clinical characteristics of AE were psychiatric and sleep disorder, altered consciousness, prodromal, and seizure. Psychosis, delirium, seizure, and autonomic dysfunction tended to be found in seropositive NMDA AE. Inflammation in systemic, cerebrospinal fluid, and MRI findings as well as EEG abnormalities commonly occurred in AE, especially seropositive NMDA.

Abstrak :

Introduksi: Rekonstruksi mandibula pada kasus-kasus tumor mandibula menggunakan flap fibula bebas merupakan hal penting untuk mengembalikan fungsi dan estetik pada defek pascareseksi. Penelitian ini ditujukan untuk menilai hubungan karakteristik klinis dengan fungsi menelan, fungsi bicara, fungsi makan, dan kualitas hidup pada pasien yang dilakukan rekonstruksi mandibula menggunakan flap fibula bebas pascamandibulektomi.

Metode: Dilakukan studi dengan desain potong lintang dan survei mengikutsertakan pasien yang dilakukan rekonstruksi mandibula menggunakan flap fibula bebas pascamandibulektomi di RSCM pada tahun 2014-2019. Dilakukan penilaian terhadap kelas defek mandibula, panjang defek, jumlah subunit mandibula, ekstensi defek, jumlah segmen tulang, selanjutnya dilakukan penilaian fungsi melalui wawancara menggunakan European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35).

Hasil: Tercatat 63 pasien dengan mandibulektomi dan dilakukan rekonstruksi. Hanya 14 dapat dinilai. Hanya panjang defek dan ekstensi defek yang memiliki hubungan bermakna dengan fungsi. Panjang defek mandibula memiliki korelasi positif dengan gangguan pada fungsi menelan (p = 0,032), fungsi bicara (p = 0,020), dan kualitas hidup (p = 0,032). Ekstensi defek intraoral dan ekstraoral menyebabkan gangguan fungsi menelan (p = 0,035).

Konklusi: Penelitian ini menunjukkan bahwa fungsi menelan, fungsi bicara, dan kualitas hidup tergantung defek pascamandibulektomi.

 

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Introduction: Mandibular reconstruction utilizing free fibula flap is essential in restoring the function, and aesthetics outcomes post mandibular tumor resection. This study looks into the association of clinical characteristics with functional outcomes such as swallowing, speaking, eating, and quality of life on patients undergoing post-mandibulectomy mandibular reconstruction using free fibula flap.

Methods: We performed a cross-sectional study that includes patients who underwent post-mandibulectomy mandibular reconstruction using free fibula flap at RSCM in 2014-2019. Mandibula defect class, defect length, the number of mandibula subunits, defect extension, and the number of osteotomy segments was evaluated. The functional outcomes were assessed using the European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35).

Results: 63 patients underwent mandibulectomy and reconstruction using free fibula flap. Only 14 were included in the study. Defect length and extension are significantly associated with functional outcomes. Mandibula defect length has positive correlation with problems in swallowing function (p = 0.032), speaking function (p = 0.020), and quality of life (p = 0.032). Both intraoral and extraoral defect extension causes swallowing function problem (p = 0.035).

Conclusion: This study discovered that swallowing function, speaking function, and quality of life are associated with post-mandibulectomy defect.

 

 

Abstrak :
Latar Belakang Kanker ginekologi dan infeksi COVID-19 memiliki tingkat insidensi dan mortalitas yang tinggi di Indonesia serta berdampak pada aspek kesehatan, sosial, dan budaya. Kanker ginekologi dan infeksi COVID-19 memicu inflamasi yang dapat mengakibatkan ganguan multi-organ. Pemeriksaan laboratorium dapat digunakan sebagai indikator keparahan untuk menilai inflamasi dan kerusakan organ. Oleh karena itu penelitian ini akan membahas mengenai analisis kakteristik klinis dan hasil laboratorium pasien kanker ginekologi dengan COVID-19. Metode Metode yang akan digunakan di dalam penelitian ini adalah deskritif dan analitik dengan pendekatan potong lintang retrospektif. Hasil Tingkat insidensi pasien kanker ginekologi dengan COVID-19 2020-2022 sebesar 154 per 100.000. Kanker serviks (54,3%) menjadi diagnosis terbanyak diikuti dengan kanker ovarium (28,7%), kanker rahim (14,9%), kanker vulva (1,1%), dan kanker vagina (1,1%). Stadium III (37,2%) menjadi yang terbanyak diikuti stadium IV (26,6%), stadium I (20,2%), stadium II (16%). Karakteristik klinis dan hasil laboratorium yang memiliki hubungan signifikan dengan stadium kanker adalah obesitas (OR 0,321; CI 0,125-0,826; P value 0,018), neutrofil absolut tinggi (OR 5,006; Cl 95%, 1,307 – 19,176; P value 0,019), ureum tinggi (OR 3,977; Cl 95%, 1,112 – 14,224; P value 0,034), dan platelet to leucocyte ratio (PLR) tinggi (OR 7,379; 95% CI 2,067-26,466; P value 0,002). Karakteristik klinis dan hasil laboratorium yang memiliki hubungan signifikan dengan derajat keparahan COVID-19 adalah sesak napas (OR 12,364; Cl 95%, 4,148 – 36,848; P value <0.001) dan PLR tinggi (OR 6,787; 95% CI 1,103 - 41,774; P value 0,039). Kesimpulan Karakteristik klinis dan hasil laboratorium yang dapat dikaitkan sebagai indikator keparahan berdasarkan stadium kanker ginekologi adalah obesitas, neutrofil absolut tingg, ureum dan PLR tinggi. Karakteristik klinis dan hasil laboratorium yang dapat dikaitkan dengan indikator keparahan berdasarkan derajat keparahan COVID-19 adalah sesak napas dan PLR tinggi. ......Introduction Gynecologic cancer and COVID-19 infection have high incidence and mortality rates in Indonesia and impact health, social and cultural aspects. Gynecological cancers and COVID-19 infections trigger inflammation that can lead to multi-organ disorders. Laboratory tests can be used as an indicator of severity to assess inflammation and organ damage. Therefore, this study will discuss the analysis of clinical characteristics and laboratory results of gynecological cancer patients with COVID-19. Method The method used in this study is descriptive and analytic with a retrospective cross- sectional approach. Results The incidence rate of gynecologic cancer patients with COVID-19 2020-2022 was 154 per 100,000. Cervical cancer (54.3%) was the most common diagnosis followed by ovarian cancer (28.7%), uterine cancer (14.9%), vulvar cancer (1.1%), and vaginal cancer (1.1%). Stage III (37.2%) was the most common followed by stage IV (26.6%), stage I (20.2%), stage II (16%). Clinical characteristics and laboratory results that had a significant association with cancer stage were obesity (OR 0,321; CI 0,125-0,826; P value 0,018), high absolute neutrophils (OR 5.006; 95% CI, 1.307-19.176; P value 0.019), high high ureum level (OR 3.977; 95% CI, 1.112-14.224; P value 0.034), and high PLR (OR 7.379; 95% CI 2.067-26.466; P value 0.002). Clinical characteristics and laboratory results that had a significant association with COVID-19 severity were shortness of breath (OR 12.364; Cl 95%, 4.148 - 36.848; P value <0.001) and high PLR (OR 6.787; 95% CI 1.103 - 41.774; P value 0.039). Conclusion Clinical characteristics and laboratory results associated with gynecologic cancer stage were obesity, high absolute neutrophils, high ureum level, and high PLR. Clinical characteristics and laboratory results associated with COVID-19 severity were shortness of breath and high PLR.

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ABSTRAK
Latar Belakang: Gagal jantung telah menjadi masalah kesehatan di seluruh dunia dan seringkali diasosiasikan dengan tingginya frekuensi perawatan di rumah sakit dan lama rawat yang panjang. Sayangnya, hingga saat ini belum ada satupun penelitian yang menggambarkan lama rawat serta profil pasien gagal jantung di Indonesia. Tujuan dari penelitian ini adalah mengetahui gambaran lama rawat dan mendeskripsikan karakteristik demografis serta karakteristik klinis dari pasien-pasien gagal jantung yang dirawat di RSUPN-CM pada tahun 2012

Metode: Dilakukan suatu studi dengan desain potong lintang dengan menggunakan data sekunder dari rekam medis pasien-pasien gagal jantung di RSUPN-CM selama tahun 2012. Selanjutnya dilakukan pengolahan data secara deskriptif untuk kemudian ditampilkan.

Hasil: Terkumpul data 331 pasien gagal jantung yang dirawat selama tahun 2012. Median usia adalah 58 tahun, 62,2% di antaranya adalah pria, dan 42,9% menggunakan jaminan sosial Askes/In-Health. Tingkat pendidikan yang terbanyak adalah pendidikan SMU dan sederajat sebanyak 23,9%. Median lama rawat 8 hari didapat dari perhitungan yang dilakukan terhadap semua pasien (NYHA I – IV), namun pada mereka yang dirawat dengan kelas fungsional NYHA III – IV saja, median lama rawatnya 9 hari. Pada awal perawatan, median tekanan darah sistolik 124 mmHg, denyut nadi 90 kali permenit, edema perifer terdapat pada 36,9% pasien, hipertensi 57,1%, diabetes mellitus 33,2%, penyakit jantung iskemik 74,9%, gangguan fungsi ginjal pada 46,2%, penyakit saluran pernafasan akut pada 45,9%, dan skor CCI terbanyak adalah 3.

Kesimpulan: Median lama rawat pasien gagal jantung di RSUPN-CM adalah 8 – 9 hari. Sebagian besar pasien adalah pria, berpendidikan SMU, dan menggunakan jaminan Askes/In-Health dengan median usia 58 tahun.

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ABSTRACT
Introduction: Heart failure has become global health issue worldwide, as it has been associated with high rate of readmissions and prolonged hospitalizations. Indonesia has never had any publication describing the profile and length of hospital stay of their heart failure patients. Hence, the aim of this study is to obtain the length of hospital stay and describe the demographic characteristic as well as clinical characteristic of heart failure patients in Cipto Mangunkusumo General Hospital hospitalized in the year of 2012.

Methods: A cross sectional study was designed using secondary data from heart failure patients’ medical records in Cipto Mangunkusumo General Hospital admitted during 2012. Furthermore, data were calculated and presented thereafter.

Results: Based on the medical records of the year 2012, 331 heart failure patients were included in the study. Median age was 58 years old, 62,2% were men, 42,9% used Askes/In-Health as their social insurance payor, and as many as 23,9% had graduated from senior high school level. Median length of stay was 8 days for all patients, while for patients admitted with NYHA functional class III – IV, the median length of stay was 9 days. When patients were admitted to hospital, median systolic blood pressure was 124 mmHg, pulse 90 beats per minute, peripheral edema was shown in 36,9% of patients, hypertension in 57,1%, diabetes mellitus in 33,2%, ischemic heart disease in 74,9%, renal impairment in 46,2%, acute respiratory conditions in 45,9% of patients, and the most frequent CCI score was 3.

Conclusions: Median length of stay for heart failure patients in Cipto Mangunkusumo GH is 8 – 9 days. Most patients were men, senior high school graduate, and used Askes/In-Health as their social insurance, with median age 58 years old.