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"ABSTRAK Objektif : Penyakit arteri periper PAP atau periperal artery Disease PAD merupakan penyakit obstruktif pda extremitas bawah yang dihubungkan dengan kondisi kritis iskemik exremitas bawah dengan resiko amputasi. Kegagalan pada penyembuhan luka operasi pasca below knee amputasi adalah multi faktorial, salah satunya ditekankan kepada penilaian kualitas aliran darah pada tingkat level amputasi.Ultrasonografi merupakan alat pemeriksaan yang cukup ideal untuk menilai kondisi arteri pada extermitas, oleh karena itu penelitian ini dilakukan untuk mencari hubungan antara hasil pemeriksaan ultrasonografi dengan kesembuhan luka operasi below knee amputasi extermitas yang nantinya di jadikan indikator prediktif kesembuhan. Metode : Penelitian ini menggunakan studi case control retrospektif untuk mencari hubungan hasil pemeriksaan ultrasonografi peak systolic, diameter, volume flow, spectral wave arteri poplitea, arteri tibia anterior dan arteri tibia posterior pada pasien yang menderita penyakit arteri periper PAP di RSUPN Cipto Mangunkusumo, RSUP Fatmawati dan RSUD Tangerang dari tahun 2015-2017 dengan kesembuhan luka operasi below knee amputasi. Hasil : Dari penelitian yang dilakukan pada 58 pasien pada Arteri Poplitea memiliki nilai mean Peak Systolic Velocity PSV 72,22 11,5 cm/s , diameter 0,52 0,008 cm. dan volume flow 109,3 30 ml/min. Arteri Tibia Anterior memiliki Peak Systolic Velocity PSV rata-rata 45,65 3,5 cm/s, diameter 0,25 0,01 cm dan 47,9 5,2 ml/min. Arteri Tibia Posterior memiliki Peak Systolic Velocity PSV rata-rata 42,6 2,76 cm/s, diameter 0,25 0,01 cm dan 34,07 3,7 ml/menit. Semua hasil pemeriksaan ultrasonografi menujukan hasil yang signifikan dengan kesembuhan p ABSTRACT Objective Peripheral artery disease PAD is an obstructive disease of lower extremity associated with critical ischemic condition of the lower exremitas with the risk of amputation. Failure in wound healing operations after below knee amputation is multi factorial, one of which is emphasized on the assessment of the quality of blood flow at the level of amputation levels. Ultrasonography is an ideal examination tool to assess the condition of the arteries in the extermitas, therefore this study was conducted to find the relationship between ultrasonografy examination results with wound healing operations below knee amputation extermitas which later on make predictive indicator of healing. Metode This study used a retrospective case control study to investigate the relationship of ultrasound examination results peak systolic, diameter, volume flow, spectral wave popliteal artery, anterior tibial artery and posterior tibial artery in patients with peripheral artery disease PAP at RSUPN Cipto Mangunkusumo, RSUP Fatmawati and RSUD Tangerang from 2015 2017 with wound healing operation below knee amputation. Result From the research conducted on 58 patients in Poplitea Artery has mean value of Peak Systolic Velocity PSV 72,22 11,5 cm s, diameter 0,52 0,008 cm. And the flow volume is 109.3 30 ml min. Anterior Tibia Artery has Peak Systolic Velocity PSV averaging 45.65 3.5 cm s, diameter 0.25 0.01 cm and 47.9 5.2 ml min. Tibia Posterior Artery has Peak Systolic Velocity PSV averaging 42.6 2.76 cm s, diameter 0.25 0.01 cm and 34.07 3.7 ml min. All ultrasound examination results showed significant results with a growth rate of p "

"[Penyakit Arteri Perifer (PAP) merupakan sumbatan aliran darah arteri selain koroner dan intrakranial. PAP dihasilkan dari proses atherosklerosis, emboli, trombus, dan inflamasi yang mengarah ke stenosis arteri. PAP asimptomatik menempati 3-10% populasi dunia, dan meningkat hingga 15-20% pada 70 tahun ke atas. Divisi kami mencatat 18,1-24,7% pasien kaki diabetik dengan PAP mengalami amputasi pada kurun waktu 3 tahun terakhir. Evaluasi ultrasonografi Doppler pada arteri utama ekstremitas bawah diharapkan mampu mendeteksi secara dini apakah pasien akan diamputasi atau tidak baik mayor maupun minor. Metode yang diambil adalah analitik komparatif kategorik independen dengan disain penelitian kohort retrospektif. Selama Januari 2010 hingga Desember 2011 didapatkan 24 pasien yang masuk kriteria inklusi. Arteri yang diperiksa a.femoralis, a.poplitea, a.tibialis posterior, dan a.dorsalis pedis dengan tampilan spektral mulai dari monofasik, bifasik, atau trifasik terutama dengan pelebaran spektral. Ultrasonografi salah satu modalitas ?operator dependent?, untuk mengurangi bias, peneliti menggunakan operator ultrasonografi adalah peneliti sendiri, trainee atau konsultan divisi kami. Hasil didapatkan spektral bifasik hingga monofasik pada a.femoralis 25,0%, a.poplitea 58,3%, a.tibialis posterior 41,6%, a.dorsalis pedis 45,8%, angka amputasi mayor dan minor masing-masing 4%. Perhitungan statistik didapatkan untuk a.femoralis p=0,054 (95% CI), a.poplitea p=0,006 (95% CI), a.tibialis posterior p=0,010 (95% CI), dan a.dorsalis pedis p=0,021 (95% CI). Secara statistik, prediksi amputasi dapat bermakna pada ultrasonografi Doppler pada a.poplitea, a.tibialis posterior, dan a.dorsalis pedis. Dapat ditarik kesimpulan pemeriksaan ultrasonografi Doppler penting dilakukan pada setiap pasien PAP untuk mengevaluasi secara khusus keadaan empat arteri utama ekstremitas bawah pasien dan untuk prediktor amputasi

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Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss., BACKGROUND

Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation.

METHODS

Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division.

RESULTS

Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI).

CONCLUSION

Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.]"

"[ABSTRAKLatar Belakang : Atherosklerosis adalah suatu proses penyakit yang difus, dengan adanya satu pembuluh darah yang rusak akan memprediksikan adanya kelainan pada pembuluh darah lain. Ankle Brachial Indeks (ABI) dan Toe Brakhial Indeks (TBI) adalah test non invasif terbukti sensitive dan spesifik untuk mendeteksi beratnya penyakit arteri perifer.Tujuan : Mengetahui hubungan derajat Penyakit Arteri Perifer (PAP) Asimtomatis dengan beratnya Penyakit Jantung Koroner (PJK) stabilMetode : Dilakukan studi potong lintang pada tujuh puluh tiga pasien PJK stabil yang menjalani angiografi koroner. Derajat stenosis arteri coroner dinilai dengan skor Gensini > 40 (berat) dan < 40 (ringan-sedang). PAP dinilai dengan pemeriksaan ABI dan TBI dengan metode Oscillomtreic. Analisis menggunakan uji Spearman correlation test dan uji Pearson correlation test.Hasil : Proporsi PAP asimtomatis pada PJK stabil 47 pasien (64,4%). Nilai median ABI adalah 1,07 (kisaran 0,57-1,27), nilai rerata TBI adalah 0,57 (SB 0,155) dan nilai rerata skor Gensini adalah 46,60 (SB 33,64). Analisis bivariat ABI dengan skor Gensini menunjukkan tidak terdapat korelasi (r=-0,099, p 0,407) dan analis bivariate TBI dengan skor Gensini juga menunjukkan tidak terdapat korelasi (r= -0,153, p= 0,196)Simpulan : ABI dan TBI dengan metode Oscillometric tidak berkorelasi dengan derajat stenosis arteri koroner berdasarkan skor Gensini. ABI dan TBI tidak memiliki kemampuan yang baik untuk membedakan pasien PJK ringan-sedang dan berat berdasarkan skor Gensini.

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ABSTRACTIntroduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.;Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores., Introduction : Atherosclerosis is a diffuse disease process; in which damaged of a blood vessel will predict abnormalities in other blood vessels. Ankle Brachial Index (ABI) and Toe Brachial Index (TBI) are non-invasive tests, which are proved to be sensitive and specific for detecting and assessing the severity of peripheral arterial disease.Objective : This study was aimed to evaluate of correlation between the degree Peripheral Arterial Disease (PAP) asymptomatic with the severity of stable coronary heart disease (CHD)Method : This cross-sectional study was conducted on seventy-three patients with stable CAD undergoing coronary angiography. The severity of coronary artery stenosis was assessed using a GENSINI scoring system, which scores > 40 were considered severe and scores <40 were considered mild to moderate. Peripheral Arterial Disease was assessed by examination of ABI and TBI with oscillomtric method. Spearman correlation and Pearson correlation tests were used to evaluate the correlation between the studied variables.Results : The proportion of asymptomatic CHD in stable PAP was 47 patients (64.4%). The median value of ankle brachial index was 1.07 (range from 0.57 to 1.27), the mean score of Toe Brachial Index (± 0.155) and the mean score of GENSINI was 46.60 (± 33.64). There was no significant correlation between ankle brachial index and Toe Brachial Index with the GENSINI score with p=0.407 (r = -0.099) and p= 0.196 (r = -0.153), respectively. Conclusion : The study revealed that ABI and TBI with oscillometric method were not correlated with the degree of coronary artery stenosis defined by the GENSINI score. ABI and TBI did not have a good potential to distinguish patients with mild-moderate and severe stable CHD based on the GENSINI scores.]"

"Tujuan: Mengetahui gambaran arteri karotis pada pemeriksaan ultrasonografi Doppler berwarna pada pasien-pasien stroke iskemik di RSUPN CM. Bahan dan Cara: Tiga puluh satu pasien dengan stroke iskemik dilakukan pemeriksaan ultrasonografi Doppler berwarna pada arteri karotis bilateral. Semua pasien telah dilakukan pemeriksaan CT Scan kepala dan penilaian adanya faktor risiko seperti hipertensi, diabetes melitus, hiperkolesterol dan merokok. Pada pemeriksaan ultranografi Doppler berwarna terhadap karotis, dinilai IMT, plak, diameter stenosis dan gangguan aliran. Selain itu dinilai juga hubungan antara faktor risiko terhadap terjadinya plak. Hasil: Dari 31 pasien stroke iskemik yang dilakukan ultrasonografi Doppler berwarna karotis didapatkan 16 pasien (51,6%) dengan penebalan intima, 21 pasien (67,7%) mempunyai plak pada arteri karotis. Sebagian besar plak berlokasi di bifurksio karotis (71,0%), dengan struktur heterogen dan permukaan reguler (74,2%). Hanya 2 plak (6,5%) yang menimbulkan stenosis lebih dari 50%. Sebanyak delapan belas (72%) dari 25 pasien penderita hipertensi dan 7 (70%) dari 10 pasien penderita diabetes mellitus mempunyai plak pada arteri karotis. Kesimpulan: Pada penelitian ini didapatkan lokasi plak tersering di bifurkasio karotis, struktur plak terbanyak heterogen dengan permukaan yang reguler. Tidak terdapat hubungan yang signifikan antara faktor-faktor risiko terhadap terbentuknya plak."

"Latar Belakang: Prevalensi penyakit arteri perifer PAP pada pasien dengan penyakit ginjal kronik PGK terlihat meningkat sejak stadium 3. Alat diagnostik nilai indeks ankle brachial ABI cukup akurat dalam mendeteksi PAP pada populasi normal. Pada PGK yang sering terjadi kalsifikasi pembuluh darah dimana nilai ABI dapat menjadi normal atau tinggi meski sudah ada stenosis pembuluh darah. Kalsifikasi pada ibu jari jarang terjadi membuat pemeriksaan nilai indeks toe brachial TBI mempunyai kelebihan dalam menilai PAP pada PGK.Tujuan: Untuk mendapatkan proporsi PAP berdasarkan nilai ABI dan TBI serta informasi mengenai profil PAP pada PGK predialisis dan faktor yang diduga berhubungan. Metode: Penelitian potong lintang pada pasien PGK di poliklinik Ilmu Penyakit Dalam, poliklinik Ginjal Hipertensi, poliklinik Kardiologi dan poliklinik Kardiologi Pusat Jantung Terpadu RSCM periode Oktober 2015-Maret 2016. Data didapatkan dari hasil wawancara, pemeriksaan fisik, nilai ABI dan TBI, serta pemeriksaan laboratorium. Studi deskriptif dilakukan dengan melihat proporsi PAP berdasarkan nilai ABI dan TBI, proporsi variabel dan penentuan nilai rerata dan median. Hasil: Terdapat 75 pasien yang memenuhi kriteria penelitian. Proporsi PAP berdasarkan nilai ABI dan TBI 60 IK 95 49 -; 71. Nilai ABI. 0,9 dan TBI. 0,7 digunakan sebagai cut off dalam diagnosis PAP. Proporsi PAP pada tiap stadium ginjal mulai terlihat besar. Pasien dengan PAP lebih banyak laki-laki 51,1 dan rerata IMT 23,57 3,5 kg/m2. Median usia pasien 64 tahun 33-74 tahun. Nilai median ABI 1,04 0,7-1,26 dan TBI 0,61 0,31-0,74. Sebagian besar tidak merokok 53,3, mempunyai komorbiditas hipertensi 84, diabetes melitus 64, penyakit jantung koroner 57 dan dislipidemia 40. Nilai median laju filtrasi glomerulus 31,6 6,3-57,6, nilai median albuminuria 153 mg/g kreatinin 7,9-10767,3, nilai median kalsium. mg/dL 7,2-9,8 mg/dL, nilai median fosfat 3,9 mg/dL 1,9-5,7 mg/dL, rerata nilai produk CaxPO4 33,7 6,5 mg2/dL2 dan nilai median hsCRP 1,3 mg/L 0,1-19,19 mg/L. Proporsi pasien dengan hipertensi lebih besar pada pasien dengan PAP. Sementara proporsi DM tidak terkontrol lebih besar dibandingkan yang terkontrol 44. 20. Simpulan: Proporsi PAP pada pasien PGK predialisis berdasarkan nilai ABI dan TBI sebesar 60. PAP pada PGK predialisis lebih banyak pada subjek dengan komorbiditas, diabetes melitus yang tidak terkontrol, stadium. klasifikasi Fontaine dan kecenderungan albuminuria yang meningkat.

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Background The prevalence of peripheral artery disease PAD in chronic kidney disease patients is increasing in CKD stage. or higher. Ankle brachial index is an accurate diagnostic tool in population without CKD. Higher prevalence of arterial calcification in CKD can lead to. normal or high ABI in stenotic vessel. Toe vessels are less susceptible to calcification, therefore toe brachial index TBI measurement can be more useful for PAD assessment in CKD population.

Objectives: The aim of the study is to determine the profile of PAD based on ankle brachial index and toe brachial index in predialysis CKD patients.

Methods: cross sectional study was conducted in outpatient clinics of Dr. Cipto Mangunkusumo hospital from October 2015 to March 2016. The data were obtained by interview, ABI and TBI measurement, and analyzing the laboratories values.

Results: In 75 patients ABI and TBI measurement were conducted simultaneously. ABI 0.9 and or TBI 0.7 had been used as cut off values for diagnosing PAD. PAD proportion based on ABI and TBI in CKD predialysis is 60 IK 95 49 - 71. PAD proportion in every CKD stage are high. Most of the subject are male 51.1 and the mean body mass index value is 23.57 3.5 kg m2. The age median is 64 year old 33 74 year old. The median value of ABI is 1.04 0.7 1.26 and TBI 0.61 0.31 0.74. Most of the patients are non smoker 53.3, had hypertension 84, diabetic 64, coronary artery disease 57 and dyslipidemia 40. Median value of glomerulus filtration rate is 31.6 ml menit 1.73 m2 6.3 57.6 ml menit 1.73 m2, median value of albuminuria 153 mg. kreatinin 7.9 10767.3 median value of calcium. mg dL 7.2 9.8 mg dL, median value of phosphate 3.9 mg dL 1.9 5.7 mg dL, mean value of CaxPO4 product is 33.7 6.5 mg2 dL2 and median value of hsCRP 1.3 mg. 0.1 19.19 mg.. Most patient with PAD had. greater proportion of hypertension. The proportion of uncontrolled diabetes are higher in patient with PAD 44 vs 20.

Conclusion PAD proportion based on ABI and TBI is 60 IK 95 49 - 71. Most of the patients with PAD in CKD predialyis are with uncontrolled diabetes, stage II of Fontaine classification, increased albuminuria. "

"Diabetes Mellitus (DM) merupakan faktor risiko yang paling dominan menyebabkan Coronary Artery Disease (CAD). Pasien DM yang disertai dengan komplikasi CAD biasanya akan mengalami gejala Atypical angina. Gejala ini biasanya sangat sulit untuk dikenali sebagai nyeri angina yang khas pada pasien CAD, diperlukan pemeriksaan lebih lanjut untuk menegakkan diagnosis CAD. Ankle Brachial Index (ABI) merupakan indikasi adanya Peripheral Vascular Disease (PVD). PVD yang disertai neuropati dan infeksi pada pasien DM tipe 2 biasanya mengindikasikan adanya penyempitan pada pembuluh darah jantung. Penelitian ini bertujuan untuk mengetahui bagaimana hubungan antara gangguan vaskuler perifer dengan gejala Atypical angina pada pasien DM tipe 2 yang memiliki komplikasi CAD. Desain penelitian ini menggunakan analitik korelasi dengan rancangan cross- sectional pada responden sebanyak 83 pasien. Hasil Anallisis menggunakan Chi- square didapatkan bahwa nilai ABI rendah (obstruksi) memiliki hubungan dengan gejala Atypical angina pada pasien DM tipe 2 yang memiliki komplikasi CAD (p: 0,02). Berdasarkan hasil penelitian ini, perawat perlu melakukan intervensi yang tepat guna mencegah te1jadinya komplikasi CAD pada pasien DM tipe 2.

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Diabetes Mellitus is the most predominant risk factor that caused to coronary artery disease. Diabetes patient who are experiencing complication of coronary artery disease commonly experiencing atypical angina. These atypical angina symptoms usually difficult to identify, not like angina pain which is specific to coronary miery disease. Therefore it is needed further diagnostic examination to diagnose coronary artery disease. Ankle Brachial Index (ABI) can be used as one option in early diagnostic of peripheral vascular disease (PVD). PVD with neuropathies problem and infection on Diabetes type 2 patients commonly experience narrowing coronary blood vessels.

The purpose of this study was to examine the correlation between alterations on peripheral vascular with atypical angina on coronary artery disease patient with history of Diabetes Mellitus Type 2 who have complication of coronary artery disease. This is correlation analytic study using cross-sectional approach recruited 83 patients in the study. The result shows that the low ABI score when the patient experience obstructions, has significant correlation with atypical angina on DM patient type 2 who had CAD (p=0.02). It is suggested that nurses should implement nursing intervention that prevent complication of CAD on Diabetes patient type 2."

"Latar belakang: Intervensi endovaskular aorta perkutan rutin dilakukan dan menjadi pilihan tatalaksana invasif aneurisma atau diseksi aorta serta penyakit katup aorta. Komplikasi vaskular pasca intervensi sering terjadi pada pasien dengan diameter arteri femoralis komunis yang lebih kecil. Namun terdapat perbedaan bermakna dari diameter arteri femoralis komunis antara populasi Kaukasia dan Asia terkait komplikasi vaskular. Pada populasi Indonesia belum ada data terkait diameter arteri femoralis komunis dengan komplikasi vaskular. Tujuan: Mengetahui diameter minimal arteri femoralis komunis sebagai prediktor komplikasi vaskular pasca intervensi endovaskular aorta perkutan pada populasi Indonesia. Metode: Pasien yang dilakukan intervensi endovaskular aorta perkutan, diukur diameter arteri femoralis komunis dengan CT scan. Pasien dievaluasi kejadian komplikasi vaskular selama perawatan pasca tindakan. Hasil: Terdapat 101 pasien dengan 135 arteri femoralis komunis yang menjadi sampel penelitian. Dibagi menjadi dua kelompok ukuran diameter arteri femoralis komunis berdasarkan median 7,6 mm, yaitu diameter ≥7,6 mm dan diameter <7,6 mm. Dari analisis multivariat, tidak terdapat hubungan bermakna antara kategori diameter arteri femoralis komunis dengan komplikasi vaskular pasca intervensi endovaskular aorta perkutan (p 0,38). Variabel lain yang berhubungan dengan kejadian komplikasi vaskular adalah jenis kelamin perempuan (p 0,03) dan RSAF ≥0,82 (p <0,001). Kesimpulan: Diameter arteri femoralis komunis tidak dapat menjadi prediktor kejadian komplikasi vaskular pasca intervensi endovaskular aorta perkutan pada populasi Indonesia karena berdasarkan analisis multivariat tidak ditemukan hubungan yang bermakna.

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Background: Percutaneus endovascular aorta repair has been routinely performed and become the primary choice of invasive therapy for aortic aneurism, aortic dissection and aortic valve disease. The occurrence of vascular complications resulting from intervention, often occurs in patients with smaller common femoral artery. However there is a significant difference in the diameter of common femoral artery between the Caucasian and Asian populations related to the incidence of vascular complications. Objectives: To investigate the minimal diameter of common femoral artery as a predictor of vascular complications after percutaneus endovascular aorta repair in the Indonesian population. Methods: Patients who performed percutaneus endovascular aorta repair, measured the diameter of the common femoral artery with a CT scan and than evaluated for the occurrence of vascular complications after procedure. Results: 101 patients with 135 common femoral arteries are divided into two groups based on median of common femoral arteries (7,6 mm), diameter ≥7,6 mm and diameter <7,6 mm. From multivariate analysis, there is no significant association between the common femoral artery diameter and vascular complications after percutaneous aortic endovascular repair (p 0,38). Other variables that related to the incidence of vascular complications were female (p 0.03) and RSAF ≥0.82 (p <0.001). Conclusion: Diameter of common femoral artery can not be used as predictor of vascular complications after percutaneus endovascular aorta repair in the Indonesian population because based on multivariate analysis there was no significant relationship."

"Upaya pemulihan kondisi pasca-amputasi dapat dilakukan dengan berbagai cara, salah satunya dengan mobilisasi dini. Mobilisasi yang tidak tepat meningkatkan morbiditas perioperatif dan lama rawat, serta memperlambat proses penyembuhan luka. Tujuan penulisan untuk menganalisis intervensi mobilisasi secara aman pada pasien pasca- amputasi bawah lutut menggunakan metode Metode yang digunakan dengan menerapkan latihan mobilisasi selama 6 hari berturut-turut, sebanyak 2 kali dalam sehari, serta dilakukan selama 30 menit setiap kali latihan. Latihan meliputi latihan tungkai, perubahan posisi, berdiri seimbang dan berpindah posisi. Hasil evaluasi hari ke 6 klien mampu latihan gerak tungkai, berubah posisi serta posisi secara mandiri. Berdiri seimbang dan berpindah posisi dari tempat tidur ke kursi roda dengan bantuan serta terdapat peningkatan kekuatan otot pada ekstremitas bawah. Mobilisasi dini pasca- amputasi diperlukan sebagai upaya pemulihan kondisi pasien dan melatih kemampuan berjalan.

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Efforts to restore post-amputation conditions can be done in various ways, one of which is early mobilization. Improper mobilization increases perioperative morbidity and length of stay, and reduces wound healing. The purpose of this paper is to analyze the interventions of safely mobilization to post below knee amputation using SAFEMOB method. This study used method which applied mobilization exercises for 6 consecutive days in 2 times a day, for 30 minutes each exercise. Exercises involve leg exercises, position changes, dangling, standing balanced and moving positions. The results of the 6 day evaluation, the patient was able to train joint movements, change position and dangling independently. Standing in balance and shifting from bed to wheelchair with help also lies in increasing strength in the lower extremities. Early mobilization post- amputation is needed as an effort to restore the patients condition and practice walking skills. "

"Latar belakang: Bedah pintas arteri koroner merupakan tindakan yang memiliki risiko kematian. Terdapat beberapa skor prediksi mortalitas jangka pendek yang saat ini digunakan untuk memprediksi risiko kematian 30 hari pasien pasca-bedah pintas arteri koroner salah satunya skor ACEF. Namun skor yang telah digunakan saat ini masih memerlukan penyempurnaan karena kemampuan prediksinya yang belum optimal. Peningkatan kadar glukosa darah berkaitan erat dengan peningkatan mortalitas. Namun peranan glukosa darah sebagai prediktor mortalitas belum terdapat dalam skoring ACEF.Tujuan: Mengetahui kemampuan kadar glukosa darah satu jam pasca-bedah pintas arteri koroner sebagai prediktor mortalitas 30 hari dan kemampuan sebagai modifikator skor ACEF.Metode: Studi kohort retrospektif dengan menelusuri rekam medis pasien yang menjalani prosedur bedah pintas arteri koroner di RSUPN Cipto Mangunkusumo periode januari 2015 hingga desember 2022. Pada data umur, kreatinin, fraksi ejeksi, glukosa darah sewaktu satu jam pasca-bedah pintas arteri koroner dan kematian dari rekam medis pasien dibuat model prediksi dan dilakukan analisis performa diskriminasi dan kalibrasi.Hasil: Glukosa darah sewaktu satu jam pasca-bedah pintas arteri koroner dan variabel ACEF dari 322 pasien dikaji dan dianalisis. Terdapat 11,8% pasien meninggal dengan median Glukosa Darah Sewaktu satu jam pasca-bedah pintas arteri koroner 220.  Glukosa darah sewaktu satu jam pasca-bedah pintas arteri koroner memiliki AUC terbesar 0,537. Skor ACEF memiliki AUC 0,843. Modifikasi skor ACEF dengan glukosa darah sewaktu satu jam pasca-bedah pintas arteri koroner berupa skor prediksi baru memiliki AUC 0,843Simpulan: Glukosa darah sewaktu satu jam pasca-bedah pintas arteri koroner tidak dapat memprediksi mortalitas 30 hari.

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Background: Coronary Artery Bypass Graft Surgery (CABG) is one of cardiac surgery with risk of mortality. There are already many scores to predict mortality in 30 days after CABG, one of them is ACEF score. Although it is relatively easy to use, ACEF score is still considered imperfect. Other studies have shown that hyperglycemia increases risk of mortality, including post CABG. Hyperglycemia or blood glucose is still rarely found in established scoring systems.

Objective: To find added predictive value of adding blood glucose to ACEF score in predicting 30-days post CABG mortality.

Methods: This study is a retrospective cohort study. Data was collected from medical records of patients who went CABG in RSUPN Cipto Mangunkusumo from January 2015 to December 2022. Age, creatinine, ejection fraction, and mortality were analyzed and synthesized to make new models. We calibrated and found the discrimination of new model.

Results: We analyzed one hour-post CABG blood glucose level and ACEF score component from 322 patients. Thity-day mortality following surgery was observed in 38 subjects (11.8%). The median blood glucose was 220. The AUC of blood glucose to predict 30-days mortality is 0,537. The AUC of ACEF score in this study is 0,843. The model of adding blood glucose to ACEF score has AUC 0,843.

Conclusion: One hour post CABG blood glucose level didn’t add predictive value to ACEF of 30 days post CABG mortality."

"Stroke yang disebabkan karena gangguan perfusi otak merupakan penyebab utama disabilitas dan kematian di seluruh dunia. Komplikasi stroke dengan angka mortalitas tinggi yaitu edema luas akibat infark arteri serebri media/middle cerebral artery (MCA) maligna yang kemudian diikuti deteriorasi neurologis cepat dan berujung pada luaran yang buruk dengan angka kematian sebesar 80%. Kraniektomi dekompresi sebagai tatalaksana infark MCA maligna diketahui dapat meningkatkan probabilitas keselamatan hingga lebih dari 80%. Penelitian ini bertujuan untuk mengetahui angka kesintasan dan kualitas hidup pasien infark MCA maligna 1, 3, 6, dan 12 bulan pasca-operasi kraniektomi dekompresi di Indonesia, hubungan luaran dengan terapi reperfusi pendahulu, dan menganalisis faktor-faktor yang telah diketahui dapat mempengaruhi luaran, yaitu usia, waktu pembedahan, dan diameter anteroposterior kraniektomi. Penelitian ini bersifat kohort retrospektif melalui pengambilan data rekam medis pasien infark MCA maligna yang dilakukan tindakan kraniektomi dekompresi di Rumah Sakit Umum Pusat dr. Cipto Mangunkusumo (RSCM), Rumah Sakit Umum Pusat (RSUP) Fatmawati, dan Rumah Sakit Pusat Otak Nasional Prof. Dr. dr. Mahar Mardjono Jakarta (RS PON) pada tahun 2017-2022. Sebanyak 39 subjek masuk dalam kriteria inklusi. Dari seluruh subjek, sebanyak 51,3% subjek berusia <60 tahun, 48,7% dioperasi dalam waktu pembedahan <48 jam, 76,6% memiliki diameter kraniektomi 12-14 cm, dan 38,5% subjek mendapatkan terapi reperfusi pendahulu sebelum operasi. Dari hasil penelitian didapatkan 12 penyintas yang hidup pada akhir follow-up. Angka kesintasan pada bulan pertama sebesar 55% yang kemudian turun menjadi 36% pada 12 bulan follow-up (Kaplan-Meier). Dari 27 subjek yang meninggal, 17 subjek meninggal dalam bulan pertama perawatan pasca-operasi di rumah sakit (rentang 1-20 hari), sedangkan sisanya meninggal di luar perawatan rumah sakit. Penyebab tertinggi kematian yang diketahui yaitu infeksi. Dari 12 penyintas, 58% memiliki luaran fungsional yang buruk (modified Rankin scale 4-5) pada akhir follow-up. Tidak didapatkan adanya perbedaan signifikan angka kesintasan (p 0,779, log rank test) maupun luaran fungsional (p 0,929, Mann- Whitney test) pada kelompok yang mendapatkan terapi reperfusi maupun tidak. Dari analisis bivariat diketahui bahwa faktor usia, waktu pembedahan, dan diameter kraniektomi tidak berhubungan signifikan dengan kesintasan maupun luaran fungsional. Dari analisis multivariat dengan melibatkan faktor-faktor tambahan di luar faktor tersebut, diketahui jenis kelamin berhubungan signifikan terhadap luaran fungsional (p 0,032) sedangkan skor National Institutes of Health Stroke Scale (NIHSS) pra-operasi berhubungan secara signifikan dengan kesintasan (p 0,028) dan luaran fungsional (p 0,004). Dari penelitian ini diketahui bahwa angka kesintasan 12 bulan pasien infark MCA Universitas Indonesia viii maligna yang dilakukan kraniektomi dekompresi yaitu sebesar 36% dan mayoritas penyintas memiliki luaran fungsional buruk. Perlu dilakukan penelitian lebih lanjut dengan menyertakan kelompok kontrol pasien infark MCA maligna yang tidak dilakukan kraniektomi dekompresi namun mendapatkan terapi konservatif maksimal agar dapat diketahui manfaat operasi melalui perbandingan luaran kedua kelompok tersebut.

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Stroke caused by impaired brain perfusion is a major cause of disability and death worldwide. Stroke complication with high mortality rate is extensive edema due to malignant middle cerebral artery (MCA) infarction which is followed by rapid neurological deterioration and leads to poor outcomes with a mortality rate of 80%. Decompressive hemicraniectomy as a treatment for malignant MCA infarction has been known to increase the probability of survival by more than 80%. This study aims to determine the survival rate and functional outcome of patients with malignant MCA infarction in 1, 3, 6, and 12 months after decompressive hemicraniectomy in Indonesia, analyse impacts of prior reperfusion therapy to outcomes, and also analyse factors that are already known to affect outcome from literatures, which are age, timing of surgery, and anteroposterior craniectomy diameter. This study was a retrospective cohort by collecting medical record data of malignant MCA infarction patients who underwent decompressive hemicraniectomy at Cipto Mangunkusumo National General Hospital, Fatmawati General Hospital, and Mahar Mardjono Jakarta National Brain Center Hospital from 2017-2022. A total of 39 subjects were included, 51.3% of them were aged <60 years, 48.7% were operated within <48 hours of onset, 76.6% had a craniectomy diameter of 12-14 cm, and 38.5% received reperfusion therapy prior to surgery. Results of the study, 12 subjects survived at the end of follow-up. The survival rate at the first month was 55% which then decreased to 36% at 12 months follow-up (Kaplan-Meier). Of the 27 subjects who died, 17 subjects died within the first month of post-operative care in the hospital (interval 1-20 days), with infection as the leading cause of death, while the rest died outside of hospital care. Of the 12 survivors, 58% had poor functional outcomes (modified Rankin scale 4-5). There was no significant difference in survival rate (p 0.779, log rank test) and functional outcome (p 0.929, Mann-Whitney test) in the group receiving reperfusion therapy or not. From the bivariate analysis, it was found that age, timing of surgery, and craniectomy diameter were not significantly related to survival or functional outcome. From the multivariate analysis including other additional factors, it was found that sex was significantly related to functional outcome (p 0.032) while the pre-operative National Institutes of Health Stroke Scale (NIHSS) score was significantly related to survival (p 0.028) and functional outcome (p 0.004). From this study, it is known that the 12-month survival rate of malignant MCA infarction patients who underwent decompressive hemicraniectomy was 36% and the majority of survivors had poor functional outcomes. Further research is needed by including a control group of patients with malignant MCA infarction who did not undergo decompressive hemicraniectomy Universitas Indonesia x but received maximum conservative therapy in order to know the benefits of surgery by comparing the outcomes of the two groups."