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Segal Abdul Aziz
Kadar procalcitonin dan perannya sebagai biomarker sepsis pada pasien tumor padat dengan metastasis jauh = Level of procalcitonin and its role as a sepsis biomarker in patient with metastatic solid tumor
"ABSTRAK
Latar Belakang: Pengaruh metastasis sebagai penyebab peningkatan procalcitonin
(PCT) pada pasien tumor padat nonsepsis masih belum jelas. Studi-studi
sebelumnya memberikan hasil yang tidak konklusif. Nilai titik potong PCT untuk
diagnosis sepsis pada tumor padat metastasis juga belum diketahui.
Tujuan: Mengetahui peran PCT dalam diagnosis sepsis pada pasien tumor padat
dengan metastasis.
Metode: Studi potong lintang terhadap pasien tumor padat yang berobat di RSCM
September-Desember 2015. Pada pasien ditentukan ada tidaknya sepsis
menggunakan kriteria sepsis ACCP/SCCM 2001, dilakukan pemeriksaan darah
perifer, serta PCT. Dilakukan analisis untuk mengetahui perbedaan kadar PCT
pasien tumor padat metastasis dan tanpa metastasis yang tidak sepsis. Selain itu,
dilakukan pula pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasien
tumor padat metastasis dengan menggunakan ROC.
Hasil dan Pembahasan: Didapatkan 112 pasien tumor padat, pria sebanyak 51%,
dengan rerata usia 47,9 ±12,47 tahun. Sebanyak 71 (63,4%) pasien sudah
didapatkan metastasis, 36 (32,1%) diantaranya sepsis, dan 6 (5,3%) mengalami
SIRS. Dari 41 (36,6%) pasien tanpa metastasis, 9 (8%) mengalami sepsis, dan 5
(4,4%) SIRS. Terdapat perbedaan bermakna kadar PCT pada pasien tumor padat
metastasis dibandingkan tanpa metastasis pada kondisi nonsepsis [0,25 ng/mL
(0,07-1,76) vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Pasien tumor padat metastasis
yang mengalami sepsis memiliki kadar PCT lebih tinggi dibandingkan nonsepsis
[3,5 ng/mL (0,66-189,4) vs. 0,25 ng/mL (0,07-1,76); p<0,001]. Dari kurva ROC
kadar PCT pada tumor padat metastasis, didapatkan AUC [0,956, IK 0,916-0,996]
untuk mendiagnosis sepsis. Nilai titik potong PCT untuk diagnosis sepsis pada
pasien tumor padat metastasis adalah 1,14 ng/mL dengan sensitivitas 86% dan
spesifisitas 88%.
Kesimpulan: Pada kondisi nonsepsis, kadar PCT pasien tumor padat metastasis
lebih tinggi dibandingkan pasien tanpa metastasis. Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis adalah 1,14 ng/mL. ABSTRACT
Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. "
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Griskalia Christine Theowidjaja
Model prediksi mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam = Prediction model of the first 3 month mortality among malignancy patients with deep vein thrombosis
"Latar Belakang. Mortalitas keganasan dengan tromboemboli vena lebih tinggi daripada keganasan tanpa tromboemboli vena. Jenis dan/atau histopatologi keganasan, stadium, terapi keganasan berisiko tinggi trombosis vena dalam, lokasi trombus, usia, imobilisasi, kateter vena sentral, D-dimer, infeksi, dan Indeks Komorbiditas Charlson berpengaruh terhadap mortalitas pasien keganasan dengan trombosis vena dalam. Belum ada data insiden kumulatif mortalitas pasien keganasan dengan trombosis vena dalam di Indonesia dan belum ada model prediksi yang mudah untuk memprediksi mortalitas pasien keganasan dengan trombosis vena dalam.
Tujuan. Mengetahui insiden kumulatif mortalitas dan membuat model prediksi berupa sistem skor prediktor mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam.
Metode. Penelitian kohort, 223 pasien keganasan dengan trombosis vena dalam di RSCM, Januari 2011-Agustus 2013, diamati 3 bulan. Variabel bebas: usia, jenis dan/atau histopatologi keganasan, stadium keganasan, terapi risiko tinggi terjadi trombosis vena dalam, lokasi trombus, imobilisasi, penggunaan kateter vena sentral, D-dimer awal saat diagnosis trombosis vena dalam, infeksi, dan Indeks Komorbiditas Charlson. Variabel dependen: mortalitas karena semua penyebab. Regresi logistik digunakan untuk mendapatkan sistem skor.
Hasil. 61,4% pasien meninggal. Prediktor yang bermakna terhadap mortalitas 3 bulan pertama adalah stadium III-IV, imobilisasi, dan infeksi; dengan masingmasing skor 2-3-2. Total skor risiko rendah (0), risiko sedang (2-4), dan risiko tinggi (5-7) mempunyai mortalitas berturut-turut 10%, 43%, 72%.
Simpulan. Insiden kumulatif mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam adalah 61,4%. Telah ditemukan model prediksi mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam.
Background. Mortality risk among malignancy with venous thromboembolism (VTE) patients is higher than malignancy patients without VTE. The type and/or histopathology of malignancy, cancer stage, high risk cancer therapy for deep vein thrombosis (DVT), thrombus location, age, immobilization, central venous catheter, D-dimer, infection, and Charlson Comorbidity Index influence the mortality of malignancy patients with DVT. There is no cumulative incidence data and an easy prediction model to predict mortality among malignancy patients with DVT.
Objective. To know the cumulative incidence of mortality and to make a prediction model (scoring system) to predict the first 3-month mortality among malignancy patients with DVT.
Methods. A cohort study of 223 malignancy patients with DVT at Cipto Mangunkusumo National Hospital between January 2011-August 2013, with 3 months of follow-up. Independent variables: age, cancer's type and/or histopathology, cancer stage, high risk cancer therapy for DVT, thrombus location, immobilization, central venous catheter, D-dimer when the patients were diagnosed with DVT, infection, and Charlson Comorbidity Index. Dependent variable: all-caused mortality. Logistic regression was used to make a scoring system.
Results. 61.4% patients died. The significant predictors were stage III-IV cancer, immobilization, and infection; with the scores 2-3-2, respectively. Total score for low risk patients (0), intermediate risk patients (2-4), and high risk patients (5-7) with the mortality 10%, 43%, 72%, respectively.
Conclusions. The cumulative incidence of the first 3-month mortality in malignancy patients with DVT was 61.4%. There is an applicable prediction model to predict the first 3-month mortality among malignancy patients with DVT."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Rabbinu Rangga Pribadi
Kekuatan genggam tangan sebagai penapis malnutrisi pada pasien kanker dibandingkan dengan patient-generated subjective global assessment = Hand grip strength as a malnutrition screening modality in cancer patients compared to patient-generated subjective global assessment
"ABSTRAK
Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harus
dievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),
namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukuran
kekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudah
dibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostik
KGT pada pasien kanker di Indonesia.
Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapis
malnutrisi pasien kanker rawat jalan di RSCM.
Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun di
poliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGT
dianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai dengan
menghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.
Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, dan
malnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT
pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf
dengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2%
dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4.
Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuan
berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasien
kanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT
Background: Malnutrition has a huge impact on cancer patients and therefore it
has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming
nature and the need of trained health personnels. Measurement of
HGS is faster and easier, but there is no sufficient information regarding its cutoff
point
and diagnostic
accuracy
for cancer
patients
in Indonesia.
Aim:
defining cut-off point and diagnostic accuracy of HGS as a malnutrition
screening modality for outpatient cancer population at RSCM.
Method: A cross-sectional study was conducted at RSCM oncology outpatient
clinic from May 4
th
-October 1
st
, 2015. Subjects were 18-59 years old. Cut-off
point and diagnostic accuracy of HGS were analyzed to generate sensitivity,
specificity, PPV, NPV, LR+, and LR- .
Result: The proportion of well nourished, moderately malnourished, and severely
malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal
HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf
respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV
92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4.
Conclusion: The optimal HGS cut-off point in male and female cancer patients
were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a
malnutrition screening modality in male and female cancer patients were good and moderately good.
;Background: Malnutrition has a huge impact on cancer patients and therefore it
has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming
nature and the need of trained health personnels. Measurement of
HGS is faster and easier, but there is no sufficient information regarding its cutoff
point
and diagnostic
accuracy
for cancer
patients
in Indonesia.
Aim:
defining cut-off point and diagnostic accuracy of HGS as a malnutrition
screening modality for outpatient cancer population at RSCM.
Method: A cross-sectional study was conducted at RSCM oncology outpatient
clinic from May 4
th
-October 1
st
, 2015. Subjects were 18-59 years old. Cut-off
point and diagnostic accuracy of HGS were analyzed to generate sensitivity,
specificity, PPV, NPV, LR+, and LR- .
Result: The proportion of well nourished, moderately malnourished, and severely
malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal
HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf
respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV
92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4.
Conclusion: The optimal HGS cut-off point in male and female cancer patients
were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a
malnutrition screening modality in male and female cancer patients were good and moderately good.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Perdana Aditya Rahman
Korelasi mean platelet volume dengan mex-sledai dan d-dimer pada pasien lupus eritematosus sistemik = Correlation of mean platelet volume with mex-sledai and d-dimer in systemic lupus erythematosus patients
"ABSTRAK
Latar Belakang
Kejadian trombosis merupakan salah satu penyebab kematian pada pasien LES, selain infeksi dan aktivitas penyakit. Faktor risiko trombosis pada LES sangat beragam seperti sindrom antifosfolipid, aterosklerosis dini, autoantibodies dan inflamasi yang akan mengaktifkan trombosit dan jalur koagulasi. Studi ini bertujuan untuk mengetahui korelasi antara MPV dengan D-dimer dan Mex-SLEDAI dan mencari titik potong dari MPV yang memberikan peningkatan D-dimer.
Metode
Studi potong lintang pada pasien LES yang tidak mengonsumsi antiplatelet/ antikoagulan. Penelitian ini mengeksklusi pasien dengan tuberkulosis/ herpes zoster aktif, wanita hamil, sepsis dan gangguan hati. Seluruh pasien dinilai aktivitas penyakitnya dengan Mex-SLEDAI dan sampel darah diambil untuk pemeriksaan MPV dan D-dimer. Korelasi antara MPV dengan Mex-SLEDAI dan D-dimer dianalisis dengan uji Spearman.
Hasil Penelitian
Enam puluh tiga subyek (62 perempuan, 1 laki-laki), dengan median usia 33 (18-55) tahun. Median durasi terdiagnosis adalah 3 (0-25) tahun. Keterlibatan mukokutan, muskuloskeletal dan nefritis didapatkan pada 82,5%, 79,4%, dan 50,7% berturut-turut. Skor Mex-SLEDAI berentang dari 0 – 13, dengan 60.3% subyek dalam kondisi remisi (< 2) dan 27% berada dalam kondisi aktif (> 5). Median dari MPV adalah 9,9 (8,2-12,9) fL dan median dari D-dimer 365,51 (97,58 – 4938,1) ng/ml. Tidak didapatkan korelasi antara MPV dengan D-dimer (r= 0,049, p= 0,700), dan MPV dengan Mex-SLEDAI (r= 0,018, p= 0,888). Tidak didapatkan perbedaan MPV antara kelompok D-dimer normal dan tinggi, yaitu 9,75 (8,6 – 12,9) dan 10,1 (8,2 – 12,8) fL, p = 0,641. Dari kurva ROC, MPV 10,3 fL memiliki sensitifitas 48,1% dan spesifisitas 75% dalam memprediksi peningkatan D-dimer.
Kesimpulan
Tidak didapatkan korelasi antara MPV dengan D-dimer dan MPV dengan Mex-SLEDAI. Tidak didapatkan perbedaan MPV antara kelompok D-dimer normal dan tinggi. Titik potong MPV untuk memprediksi peningkatan D-dimer adalah 10.3 fL.
ABSTRACT
Background
Thrombotic event is one of mortality cause in SLE patients beside infection and disease activity. Thrombotic risk factors in SLE consist of antiphospholipid syndrome, accelerated atherosclerosis, autoantibodies and inflammation that will activate platelet and coagulation cascade. This study aimed to determine the correlation between MPV with D-dimer and Mex-SLEDAI as parameter of disease activity, and to find the cut-off value of MPV that correlate with D-dimer levels.
Methods
A cross sectional study of SLE patients who do not consume antiplatelet/ anticoagulant medication. Active tuberculosis/ herpes zoster, pregnant woman, sepsis, and liver disorders were excluded. All patients were assessed for Mex-SLEDAI score and blood sample for MPV and D-dimer was taken. Correlation between MPV with Mex-SLEDAI and D-dimer was analyzed using Spearman’s analysis test.
Study Results
Sixty three subjects (62 females, 1 male), with median age 33 (18-55) years old. Median duration of diagnosis is 3 (0–25) years. Mucocutaneous, musculoskeletal and nephritis were found in 82.5%, 79.4% and 50.7% subjects respectively. Mex-SLEDAI score ranging from 0–13, 60.3% subjects are in remission (<2) and 27% in active disease (>5). Median of MPV 9.9 (8.2–12.9) fL and median of D-dimer 365.51 ng/ml (97.58–4938.10). There were no correlation between MPV with D-dimer (r=0.049, p=0.700), and MPV with Mex-SLEDAI (r=0.018, p=0.888). There is no difference of MPV among groups with normal or high D-dimer, which are 9.75 (8.6 – 12.9) and 10.1 (8.2 – 12.8) fL, p = 0.641. From ROC curve, MPV 10.3 fL had 48.1% sensitivity and 75% specificity in predicting D-dimer increment.
Conclusions
There are no correlation between MPV with D-dimer level and MPV with Mex-SLEDAI score. There is no difference of MPV among group with normal and high D-dimer levels. Cut-off value for MPV to predict increased D-dimer level was 10.3 fL.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
T58760
UI - Tesis Membership  Universitas Indonesia Library
cover
Faradiesa Addiena
Hubungan antara Limfopenia dengan Mex SLEDAI serta Terapi Imunosupresan terhadap Limfosit Total pada Pasien Lupus Eritematosus Sistemik = Association between lymphopenia and Mex SLEDAI as well as the immunosupressant therapy and total lymphocytes in systemic lupus erythematosus patients
"Latar belakang: Limfopenia merupakan manifestasi klinis yang sering terjadi pada pasien dengan LES serta mempunyai arti patologis yang bermakna. Patogenesis limfopenia saat ini masih belum jelas, namun beberapa penyebab yang diketahui adalah terdapatnya antibodi antilimfosit, penurunan CD 55 dan 59 dan apoptosis yang tidak terkontrol. Beberapa penelitian menunjukkan limfopenia berhubungan dengan aktivitas penyakit. Hal lain yang menjadi perhatian adalah pemberian terapi imunosupresan pada pasien LES dalam keadaan limfopenia dapat memperburuk limfopenia.
Tujuan: Untuk mengetahui hubungan antara limfosit total dan aktivitas penyakit serta terapi imunosupresan pada pasien LES.
Metode: Studi kohort retrospektif dengan penelusuran rekam medis pasien LES yang berobat ke RSUPN Cipto Mangunkusumo periode Januari 2020 – Desember 2020. Analisa bivariat menggunakan chi square dan fisher exact dilakukan untuk mengetahui hubungan limfopenia dengan aktivitas penyakit, serta analisa bivariat mann whitney dan wilcoxon digunakan untuk perbedaan rerata hitung limfosit dan terapi imunosupresan serta hubungan antara terapi imunosupresan terhadap limfosit total.
Hasil: Sebanyak 214 subjek memenuhi kriteri inklusi. Didapatkan hubungan bermakna antara limfopenia terhadap Mex SLEDAI pada subjek LES dalam keadaan remisi di bulan ke-3 (RR: 0,490; 95% IK: 0,320-0,751; p = 0,001) dan bulan ke-6 (RR: 0,490; 95% IK: 0,322-0,769; p = 0,001). Pada subjek LES dalam keadaan aktif terdapat hubungan bermakna antara limfopenia terhadap Mex SLEDAI pada bulan ke-3 (RR: 2,46; 95% IK: 1,71-5,188; p = 0,009). Tidak didapatkan perbedaan median limfosit total pada pasien LES dalam terapi MMF dan tanpa terapi MMF baik pada bulan ke-0 (p = 0,822), bulan ke-3 (p = 0,916), dan bulan ke-6 (p = 0,560). Tidak didapatkan juga hubungan dari limfosit total pada pasien dalam terapi MMF selama 6 bulan (p = 0,084). Didapatkan perbedaan median limfosit total pada pasien LES dalam terapi AZA dibandingkan pasien LES tanpa terapi AZA di bulan ke-0 (p = 0,044) dan bulan ke-3 (p = 0,007). Terdapat penurunan limfosit total pada bulan ke-3 pada pasien LES dalam terapi AZA namun tidak signifikan (p = 0,844). Tidak didapatkan perbedaan median limfosit total pada subjek pasien LES dalam terapi MTX baik pada bulan ke-0, bulan ke-3 dan bulan ke-6 (p = 0,510), (p=0,977), (p=0,714). Tidak didapatkan hubungan bermakna antara terapi MTX terhadap limfosit total (p = 0,721).
Kesimpulan: Terdapat hubungan bermakna antara limfopenia terhadap aktivitas penyakit pasien LES yang dihitung dengan Mex SLEDAI. Tidak terdapat hubungan bermakna antara terapi imunosupresan selama 6 bulan terhadap limfosit total pasien LES.
Background: Lymphopenia is a clinical manifestations that frequently develops in SLE patients and has important pathological implications. Although the pathogenesis of lymphopenia is still unknown, antilymphocyte antibodies, diminished CD 55 and 59, and uncontrolled apoptosis are a few of the factors that can develop inside it. Numerous investigations have demonstrated a connection between lymphopenia and disease activity. Another issue is that administering immunosuppressant therapy to SLE patients who are already lymphopenic can make their condition worsen.
Objective: To investigate the association between total lymphocytes, disease activity, and immunosuppressive treatment in SLE patients.
Methods: Retrospective cohort study by tracing the medical records of SLE patients who visited Cipto Mangunkusumo General Hospital between January 2020 and December 2020. The relationship between lymphopenia and disease activity was investigated using bivariate analysis using chi square and fisher exact, and the relationship between immunosuppressant therapy and total lymphocytes and differences in mean lymphocyte count and immunosuppressant therapy were investigated using bivariate analysis using mann-Whitney and Wilcoxon.
Results: 214 subjects fulfilled the criteria for inclusion. Lymphopenia and Mex SLEDAI were shown to be significantly associated in SLE patients in remission at months 3 (RR: 0.490; 95% CI: 0.320-0.751; p = 0.001) and 6 (RR: 0.490; 95% CI: 0.322-0.769; p = 0.001). Lymphopenia and Mex SLEDAI were significantly associated at month 3 in patients with active SLE (RR: 2.46; 95% CI: 1.71-5.188; p = 0.009). At month 0 (p = 0.822), month 3 (p = 0.916), and month 6 (p = 0.560), there was no difference in the median total lymphocyte count between SLE patients receiving MMF therapy and those receiving no MMF medication. In addition, there was no association between total lymphocytes and MMF therapy in individuals treated for 6 months (p = 0.084). At month 0 (p = 0.044) and month 3 (p = 0.007), SLE patients receiving AZA therapy had median differences in total lymphocytes compared to SLE patients not receiving AZA therapy. Patients with SLE receiving AZA medication had a decrease in total lymphocytes in the third month, but it was not statistically significant (p = 0.844). At months 0, 3, and 6, there was no difference in the median total lymphocyte count among SLE patients receiving MTX therapy (p = 0.510), (p = 0.977), and (p = 0.714). Total lymphocytes and MTX treatment had no statistically significant relation (p = 0.721).
Conclusion: The lymphopenia and disease activity of SLE patients as determined by the Mex SLEDAI are related. Immunosuppressant therapy administered for six months had no significant impact on the total lymphocyte count in SLE patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Leli Hesti
Prevalensi anemia pada pekerja pria serta faktor-faktor yang berhubungan, di Perusahaan X, 2009 = Anemia Prevalence in Male Workers and its related factors, in X Company, 2009
"Prevalensi Anemia pada Pekcrja Pria serta faktor-faktor yang berhubungan, di Perusahaan X, 2009 Program Studi : Kedokteran Kerja-Pasca Sarjana Latar Belakang Pekerja pada perusahaan migas dalam lingkungan keijanya sehari-hari banyak berhubungan dengan bahan kimia hidrokarbon aromatik terutama BTX (benzena, toluene, xylene). Adanya pajanan benzcna secara kronis dapat menyebabkan gangguan kesehatan tennasuk anemia. Oleh karena itu pcrlu diketahui prevalensi anemia pada pckeija ini sena melihat pula faktor-faktor apa saja ikut yang mempengaruhinya.
Metodologi Penelitian ini menggunakan desain penelitian potong lintang. Responden diambil secara total sanqyling yaitu sebanyak 121 responden. Setiap responden dilakukan anamncsis, pemeriksaan darah tcpi dan pemeriksaan apusan darah untuk menentukan jenis anemia yang terjadi.
Diagnosis Anemia berdasarkan kadar hemoglobin dan hitung eritrosit. Semua pemeriksaan dilakukan di sekitar tempat kerja responden dan berlangsung selama kurang lehih 20 menit untuk setiap responden. Pengambilan data dilakukan selama 14 hari mulai tanggal 28 Februaxi 2009 sampai dengan tanggal 7 Maret 2009. Analisis data dilakukan dcngan metode uji statistik kai kuadrat untuk melihat adanya hubungan antara berbagai faktor risiko dengan variabel anemia.
Hasil dan kesimpulan Dari hasil penelitian ini didapatkan bahwa 5(4,1%) orang dengan anemia berdasarkan kadar hemoglobin dan hitung eritrosit. Pajanan benzena yang menjadi faktor risiko dari pckerjaan, diukur bcrdasarkan nilai exposure raling yang berasal dari beberapa indeks pajanan diantaranya perbandingan kadar hasil pengukuran dengan NAB, jenis° APD, perawatan, penggunaan dan durasi pajanan, diperhitungkan untuk menentukan peringkat pajanan benzena terhadap pekcrja. Hasil penelitian ini menunjukkan, tidak didapatkan hubungan yang bermakna antara pajanan benzena dengan anemia.
Pada penelitian ini ditemukan sebagian besar rcsponden terpajan benzcna. Dari hasil monitoring lingkungan kerja ditemukan pajanan benzena dalam dosis rendah (0 ppm-19,47 ppm), dan pada perhitungan exposure rating benzena ditemukan nilai rendah (0~24,2). Berdasarkan analisa bivariat kebiasaan minum teh yang menunjukkan hubungan bermakna dcngan anemia (p = 0,04; OR = 015; 95% CI = 0,02-0,9), ia menjadi faktor protektif (Odds ratio = 0,15). Hasil dari analisis multivariat menunjukkan bahwa semua variabel yang diteliti tidak menunjukkan hubungan bermakna dengan terjadinya anemia.
Oil company workers exposed to aromatic hydrocarbon chemical agents especially BTX (benzena, toluene, xylene) in their work environment. Chronic Benzene exposure can cause several health disorders, as well as anemia. Therefore, it is necessary to know the prevalence of anemia in these workers as well as its related factors.
Method This study used cross sectional design. Sample selection used total population technique which used 121 respondents. Every respondent was conducted interview, laboratory examination such as haematological count and blood smear examination to confirm the type of anemia.
Anemia was diagnosed from its hemoglobin concentration and erythrocyte count. The study was conducted near the workers workplace and it took time approximately 20 minutes each. It took place for 14 days nom Fenway 28"?, 2009 ami March 1"', 2009. Chi square analysis was used to evaluate the association between anemia and its related factors.
Results, conclusion and suggestion From this study, there were 5 (4,1%) workers suffered from anemia according to hemoglobin concentration and erythrocyte count Benzene exposure that was a risk factor in their jobs, was measured according to exposure rating value that came from some exposure indexes such as ratio between measuring of benzena in workplace and treshold limit value of benzena , type of PPE, maintenance, usage and exposure duration, was count to determine exposure rating index.
This study showed that there were no significant association between benzene exposure and anemia. This study found that there were most of respondents exposed to benzene. Environmental monitoring found benzene exposure in low concentration (O ppm - l9,47 ppm), and benzene exposure rating calculation found it in low value (0 - 24,2),. According to bivariate analysis the worker who have tea consumption showed a signilicant association with anemia (p = 0.04; OR = 0.l5; 95% CI = 0.02-0.9), in other hand this variable became a protectif factor (Odds ratio = 0,l5). Multivariate analysis showed that all variable studied did not show a significant association with anemia."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2009
T29147
UI - Tesis Open  Universitas Indonesia Library
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Irma Wahyuni
Uji diagnostik rasio trombosit limfosit sebagai penapis lesi koroner kompleks dibandingkan dengan skor gensini pada sindrom koroner akut = Diagnostic test of platelet lymphocyte ratio in screening of complex coronary lesion compared to gensini score in acute coronary syndrome
"ABSTRAK
Latar Belakang: Lesi koroner kompleks berkaitan dengan prognosis buruk SKA. Pentingnya revaskularisasi awal untuk mengurangi angka morbiditas dan mortalitas. PLR berkaitan dengan kompleksitas lesi buruk dan diharapkan menjadi acuan dalam identifikasi dini lesi koroner kompleks.
Tujuan: Mengetahui akurasi diagnostik dan nilai titik potong PLR sebagai penapis lesi koroner kompleks baik pada kelompok usia ≤45 tahun dan >45 tahun.
Metode: Sebuah studi potong lintang secara retrospektif di ICCU RSUPN-CM. Data diambil dari rekam medis pasien SKA dewasa dan menjalani angiografi koroner dari Januari 2012 ? Juli 2015. Akurasi diagnositik dinilai dengan menghitung sensitivitas dan spesifisitas. Nilai titik potong ditentukan menggunakan kurva ROC.
Hasil: Proporsi pasien SKA dengan lesi koroner kompleks 47,2%. Nilai titik potong optimal pada pasien usia ≤45 tahun adalah 111,06 dengan sensivitas 91,3% dan spesifisitas 91,9. Pada kelompok usia >45 tahun nilai titik potong optimal pada angka 104,78 dengan nilai sensivitas 91,7% dan spesifisitas 58,6.
Simpulan: Nilai titik potong PLR optimal pada kelompok usia ≤45 adalah 111,06 dan kelompok usia >45 tahun adalah 104,78 dengan akurasi diagnositik masing-masing AUC 93,9% (p <0,001) dan AUC 77,3% (p <0,001).
ABSTRACT
Background: A Complex coronary lesion is related to poor prognosis in ACS patient. The importance of early revascularization is to decrease mortality and complications. Inflammatory marker such as PLR related to complex coronary lesions and expected to be a tool that can assist physicians and cardiologists to stratify patients who have high probability for having a complex coronary lesion.
Aim: Evaluate the diagnostic accuracy of PLR in identifying a complex coronary lesion in ACS patient. The other aim was to identify the proportion of complex coronary lesion and cut-off point of PLR between ≤45 years old group and >45 years old group subjects.
Method: This is a cross sectional retrospectively study in ACS patients hospitalized in ICCU of RSUPN-CM from January 2012 until July 2015. The inclusion are adult ACS patients and who underwent coronary. The diagnostic accuracy was determined by calculating the sensitivity, specificity, PPV, NPV, Positive LR, and Negative LR. The cut-off point was determined using ROC curve.
Results: The proportion of complex coronary lesion was 47,2%. The optimal cut-off point in ≤45 years old group was 111,06 with sensitivity and specificity respectively 91,3% and 91,9%. The optimal cut-off points in >45 years old groups was 104,78 with sensitivity and specificity respectively 91,7% and 58,6%.
Conclusion: The optimal cut-off point of ≤45 years old groups is 111,06 and for >45 years old group is 104,78. The diagnostic accuracy of PLR in ≤45 years old groups was very good (AUC 93,9%, p value <0,001), while in >45 years old group was moderate (AUC 77,3%, p value <0,001)."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tesis Membership  Universitas Indonesia Library
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Farieda Ariyanti
Faktor-faktor risiko kejadian sindrom pasca trombosis = Risk factors of post thrombotic syndrome
"ABSTRAK
Latar belakang: Trombosis vena dalam (deep vein thrombosis/DVT) dapat
menyebabkan komplikasi jangka panjang berupa sindrom pasca thrombosis (Post
Thrombotic Syndrome/PTS) yang menurunkan kualitas hidup pasien.
Tujuan: mengetahui proporsi dan faktor risiko PTS pada DVT ekstremitas
bawah.
Metode: Penelitian ini merupakan studi kohort retrospektif sejak Juli 2014 hingga
September 2015 di RS Cipto Mangunkusumo Jakarta. Subjek adalah pasien
dengan DVT pada tungkai bawah yang dibuktikan melalui USG (ultrasonografi)
doppler dalam waktu 3 bulan sebelum penelitian. Gejala dan tanda PTS dinilai
dengan menggunakan skala Villalta.
Hasil: Penelitian ini melibatkan 91 subjek dengan median hari saat diagnosis
DVT sampai dengan pemeriksaan PTS didapatkan 748 hari. Gejala dan tanda PTS
yang paling banyak didapatkan adalah rasa berat (63,9%) dan hiperpigmentasi
kulit (77,5%). PTS didapatkan pada 49 subjek (53,8%) dan mayoritas didapatkan
dengan PTS derajat ringan (69,3%). Jenis kelamin perempuan (RR 1.48, IK 95%
0,97-2.42) dan letak trombus proksimal-distal meningkatkan risiko terjadinya PTS
(RR 1.35, IK 95% 0.85-2.13), akan tetapi tidak signifikan secara statistik.
Kesimpulan: Proporsi PTS pasca 3 bulan pasca terjadinya DVT ekstremitas
bawah sebesar 53,8 %. Jenis kelamin perempuan dan lokasi trombus proksimaldistal
meningkatkan risiko terjadinya PTS."
2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Iqbal Ichsantyadi Awang
Nilai diagnostik viskositas plasma pasca dialisis sebagai penanda pencapaian berat badan kering pada pasien hemodialisis kronik di rsupn dr cipto mangunkusumo = Diagnostic value of post dialysis plasma viscosity as a marker of dry weight achievement on chronic haemodialysis patients in cipto mangunkusumo hospital
"Latar Belakang. Pencapaian berat kering merupakan target dari keberhasilan hemodialisis. Viskositas plasma sebagai parameter hemoreologi darah dipengaruhi oleh ultrafiltrasi pada hemodialisis. Dipikirkan viskositas plasma pasca dialisis memiliki nilai diagnostik sebagai petanda pencapaian berat kering.
Tujuan. Mengetahui korelasi antara viskositas plasma pasca dialisis dengan nilai ECW, beda reratanya antara kelompok mencapai berat kering dan tidak, serta nilai diagnostiknya sebagai penanda pencapaian berat badan kering pasien hemodialisis kronik.
Metode. Studi ini merupakan studi potong lintang yang dilakukan selama bulan Maret- April 2018. Subyek penelitian adalah pasien hemodialisis dewasa yang menjalani hemodialisis rutin di unit hemodialisis RS Cipto Mangunkusumo, Jakarta. Pencapaian berat kering dikategorikan dengan persentase cairan ekstraseluler ECW berdasarkan analisis bioimpedansi BIA. Viskositas plasma dinilai dengan instrumen Mikrokapiler Digital pada sesi hemodialisis yang bersamaan. Dilakukan uji korelasi Spearman antara parameter viskositas plasma pasca dialisis dan nilai ECW. Untuk menilai beda rerata dilakukan uji t tidak berpasangan, dilanjutkan analisis dengan Receiver Operator Curve ROC untuk memperoleh nilai AUC. Berdasarkan nilai cut off yang didapat, dilakukan analisis tabel 2x2 untuk menentukan nilai duga positif dan nilai duga negatif.
Hasil. Sejumlah 130 subjek hemodialisis dewasa berusia 19-80 tahun mengikuti studi ini, dengan median usia 52 tahun. Didapatkan korelasi sedang antara ECW dengan viskositas plasma pasca dialisis r=-0,445, p=0,000 . Diperoleh beda nilai bermakna antara kelompok pencapaian berat kering pada parameter viskositas plasma pasca dialisis p=0,000 . Area Under Curve AUC untuk viskositas plasma dan pencapaian berat kering adalah 77,2 , dengan cut off 1,62 mP diperoleh sensitivitas 71,4 , spesifisitas 75,5 , nilai duga positif 80,88, nilai duga negatif 65,41.
Simpulan. Viskositas plasma pasca dialisis memiliki hubungan sedang dan berhubungan terbalik dengan ECW sebagai tolok ukur pencapaian berat kering. Terdapat beda rerata bermakna nilai viskositas plasma pasca dialisis pada kelompok yang mencapai berat kering dan yang tidak mencapai. Viskositas plasma pasca dialisis memiliki nilai diagnostik yang cukup baik sebagai penanda pencapaian berat kering pasien hemodialisis kronik. Parameter tersebut dapat diaplikasikan dengan tetap memperhatikan gejala dan tanda klinis pasien hemodialisis kronik Kata kunci. Viskositas, plasma, hemodialisis, berat badan kering, hemorheologi.
Achievement of dry weight is a target of an effective haemodialysis. Plasma viscosity is a haemorhogical parameter of blood altered by ultrafiltration during haemodialysis. Post dialysis plasma viscosity may have diagnostic value in determining the achievement of dry weight post haemodialysis.
Objective. To evaluate post dialysis plasma viscosity correlation with ECW, its mean difference between dry weight achiever and non-achiever, and its diagnostic value in determining dry weight achievement of haemodialysis patients.
Methods. A cross sectional study on adult chronic haemodialysis patients from March-April 2018. Subjects of the study are adult chronic haemodialysis patients in Haemodialysis unit of Cipto Mangunkusumo Hospital, Jakarta. Dry weight acheivement was cathegorized using extracellular water ECW percentage based on Bioimpedance analysis BIA. Post dialysis plasma viscosity was measured using Digital Microcapillar instrument on the correlated dialysis session. Spearman correlation test was performed between post dialysis plasma viscosity and ECW. Unpaired t-test was performed to analyze mean difference. Diagnostic test using ROC curve was performed to obtain AUC. Based on the cut off, 2x2 test was performed to produce the PPV and NPV.
Result. One hundred and thirty subjects, aged 19-80 years old, with median of 52 years old enrolled for the study. Moderate negative correlations were obtained between ECW and post dialysis plasma viscosity r=-0,445, p=0,000 . Significant difference was obtained between hypervolemic and normovolemic subjects, for the parameter post dialysis plasma viscosity p=0,000 . Area under curve AUC for post dialysis plasma viscosity and dry weight achievement was 77,2 , and with 1,62 cP cut off, obtained 71,4 sensitivity, 75,5 specificity, 80,88 positive predictive value, and 65,41 negative predictive value.
Conclusion. Post dialysis plasma viscosity and delta viscosity has moderate negative correlation to ECW as dry weight determinant. Significant post dialysis plasma viscosity difference was identified between subjects achieving dry weight and those were not. Post dialysis plasma viscosity provided considerably good diagnostic value in determining dry weight achievement of haemodialysis patients. This parameter may be applied, in regard of haemodialytic patients rsquo; signs and symptoms Keywords. Viscosity, plasma, haemodialysis, dry weight, haemorheology"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58599
UI - Tesis Membership  Universitas Indonesia Library
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Griskalia Christine
Hitung jenis leukosit sebagai prediktor neutropenia akut awitan pertama pascakemoterapi R-CHOP pada pasien diffuse large B-cell Lymphoma = Differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in diffuse large B-cell Lymphoma patients
"Latar Belakang: Diffuse Large B-cell Lymphoma (DLBCL) merupakan limfoma tersering di Indonesia. Kemoterapi R-CHOP mempunyai risiko moderat untuk terjadinya neutropenia / demam neutropenia. Limfosit dapat menggambarkan imunitas pejamu, sedangkan neutrofil dan monosit dapat menggambarkan respons inflamasi. Belum ada penelitian yang menilai hitung jenis leukosit sebagai prediktor neutropenia akut awitan pertama pascakemoterapi R-CHOP pada pasien DLBCL.
Tujuan: Mengetahui hubungan parameter hitung jenis leukosit sebelum kemoterapi sebagai prediktor neutropenia akut awitan pertama pascakemoterapi R-CHOP pada pasien DLBCL.
Metode: Kohort retrospektif di RSUPN. Cipto Mangunkusumo. Pasien DLBCL 18-60 tahun, ECOG 0-1, tanpa komorbid yang berhubungan dengan kemoterapi, yang dilakukan kemoterapi R-CHOP 3 siklus pertama tanpa profilaksis G-CSF.
Hasil: Dari 95 pasien, neutropenia akut awitan pertama pascakemoterapi terjadi pada 83 (87,4%) subjek atau 83 (55,3%) siklus dari total 150 siklus kemoterapi. Demam neutropenia terjadi pada 50,6% dari awitan neutropenia. Neutropenia berat terjadi pada 34 (41,0%) siklus dari 83 episode neutropenia. Neutropenia akut awitan pertama paling sering terjadi pada 7-15 hari pascakemoterapi.
Rasio neutrofil limfosit mempunyai AUROC 0,74 (IK 95% 0,6-0,82); sedangkan limfosit absolut, neutrofil absolut, monosit absolut, dan rasio limfosit monosit mempunyai AUROC <0,70. Rasio neutrofil limfosit > 4,1 dapat memprediksi neutropenia akut awitan pertama pascakemoterapi RCHOP pada pasien DLBCL (sensitivitas 71,1%; spesivisitas 64,2%; nilai duga positif 71,1%; dan nilai duga negatif 64,2%).
Background: Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma in Indonesia. R-CHOP chemotherapy has a moderate risk for neutropenia / febrile neutropenia. Lymphocytes can describe host immunity, while neutrophils and monocytes can describe the inflammatory response. No study has assessed differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients.
Objective: To determine the relationship between differential count of leukocytes before chemotherapy as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients.
Methods: Retrospective cohort in RSUPN. Cipto Mangunkusumo. DLBCL patients 18-60 years old, ECOG 0-1, no comorbidity related to chemotherapy. Subjects were given with the first 3 cycles of R-CHOP chemotherapy without G-CSF prophylaxis.
Results: Of the 95 patients, first onset acute neutropenia after chemotherapy occurred in 83 (87.4%) subjects or 83 (55.3%) cycles of 150 chemotherapy cycles. Febrile neutropenia occurs in 50,6% of the onset of neutropenia. Severe neutropenia occurs in 34 (41.0%) cycles of 83 neutropenic episodes. The first onset of acute neutropenia is most common at 7-15 days after chemotherapy.
The neutrophil lymphocyte ratio has AUROC 0.74 (95% CI 0.65-0.82); while absolute lymphocytes, absolute neutrophils, absolute monocytes, and monocyte lymphocyte ratios have AUROC <0.70. The neutrophil lymphocyte ratio > 4.1 can predict the first onset of acute neutropenia after RCHOP chemotherapy in DLBCL patients (sensitivity 71.1%; specificity 64.2%; positive predictive value 71.1%; negative predictive value 64.2%).
Conclusion: The neutrophil lymphocyte ratio before chemotherapy > 4.1 has moderate performance in predicting the first onset of acute neutropenia post R-CHOP chemotherapy in DLBCL patients. Absolute lymphocytes count, monocytes count, neutrophils count, and monocyte lymphocyte ratio cannot be used as a predictor of the first onset acute neutropenia post R-CHOP chemotherapy in DLBCL patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T58838
UI - Tesis Membership  Universitas Indonesia Library
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