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Cut Thalya Alissya Rahma
Hubungan status albumin dengan komplikasi pasca operasi pada pasien pembedahan saluran cerna = Association between albumin status and postoperative complications in gastrointestinal surgery patients
"Latar Belakang: Pembedahan saluran cerna memiliki risiko komplikasi tinggi yang meningkatkan morbiditas, mortalitas, dan biaya kesehatan. Penurunan albumin pascaoperasi terkait inflamasi sistemik menjadi indikator penting komplikasi. Comprehensive Complication Index (CCI) digunakan untuk menilai komplikasi lebih komprehensif dibanding Clavien-Dindo Classification.
Metode:Studi kohort prospektif ini dilakukan di RSUPN Cipto Mangunkusumo pada Juli-November 2024. Subjek penelitian adalah pasien dewasa yang menjalani pembedahan saluran cerna. Dari 80 subjek awal, 78 memenuhi kriteria dengan 39 pada kelompok albumin dibawah rata-rata atau median dan 39 albumin diatas rata-rata atau median. Komplikasi pascaoperasi diukur menggunakan Comprehensive Complication Index (CCI), yang mencerminkan seluruh komplikasi pada skala kontinu 0-100, di mana skor lebih tinggi menunjukkan beban komplikasi yang lebih berat. Analisis bivariat dilakukan dengan uji Mann-Whitney untuk membandingkan skor CCI antara kedua kelompok albumin.
Hasil: Dari total 78 subjek penelitian, didapatkan nilai tengah albumin 2,85 g/dL. Kelompok dengan albumin <2,85 g/dL memiliki skor CCI lebih tinggi dibandingkan kelompok dengan albumin ≥2,85 g/dL. Analisis menunjukkan hubungan bermakna secara signifikan antara status albumin dan komplikasi pascaoperasi (p<0,05).
Kesimpulan: Status pascaoperasi berhubungan signifikan dengan komplikasi pasca pembedahan saluran cerna. Penilaian albumin dapat digunakan untuk mengidentifikasi pasien berisiko tinggi komplikasi dan merencanakan intervensi nutrisi guna mengurangi komplikasi.
Background: Gastrointestinal surgery carries a high risk of complications, increasing morbidity, mortality, and healthcare costs. Postoperative albumin decline associated with systemic inflammation serves as an important indicator of complications. The Comprehensive Complication Index (CCI) is used to assess complications more comprehensively than the Clavien-Dindo Classification.
Methods: This prospective cohort study was conducted at RSUPN Cipto Mangunkusumo from July to November 2024. The study subjects were adult patients undergoing gastrointestinal surgery. Out of 80 initial subjects, 78 met the inclusion criteria, with 39 in the <2.85 g/dL albumin group and 39 in the >2.85 g/dL albumin group. Postoperative complications were measured using the Comprehensive Complication Index (CCI), which reflects all complications on a continuous scale from 0 to 100, with higher scores indicating greater complication burden. Bivariate analysis was performed using the Mann-Whitney test to compare CCI scores between the two albumin groups.
Results: Among the 78 subjects, the median albumin level was 2.85 g/dL. CCI score in the <2.85 g/dL albumin group significantly higher than the >2.85 g/dL albumin group. These findings indicate a significant association between albumin levels and postoperative complication (p<0.05)..
Conclusion: Postoperative albumin status is significantly associated with gastrointestinal surgery complications. Albumin assessment can be used to identify high-risk patients and plan nutritional interventions to reduce complications."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2025
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UI - Tugas Akhir  Universitas Indonesia Library
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Cut Thalya Alissya Rahma
Hubungan status albumin dengan komplikasi pasca operasi pada pasien pembedahan saluran cerna = Association between albumin status and postoperative complications in gastrointestinal surgery patients
"Latar Belakang: Pembedahan saluran cerna memiliki risiko komplikasi tinggi yang meningkatkan morbiditas, mortalitas, dan biaya kesehatan. Penurunan albumin pascaoperasi terkait inflamasi sistemik menjadi indikator penting komplikasi. Comprehensive Complication Index (CCI) digunakan untuk menilai komplikasi lebih komprehensif dibanding Clavien-Dindo Classification.
Metode:Studi kohort prospektif ini dilakukan di RSUPN Cipto Mangunkusumo pada Juli-November 2024. Subjek penelitian adalah pasien dewasa yang menjalani pembedahan saluran cerna. Dari 80 subjek awal, 78 memenuhi kriteria dengan 39 pada kelompok albumin dibawah rata-rata atau median dan 39 albumin diatas rata-rata atau median. Komplikasi pascaoperasi diukur menggunakan Comprehensive Complication Index (CCI), yang mencerminkan seluruh komplikasi pada skala kontinu 0-100, di mana skor lebih tinggi menunjukkan beban komplikasi yang lebih berat. Analisis bivariat dilakukan dengan uji Mann-Whitney untuk membandingkan skor CCI antara kedua kelompok albumin.
Hasil: Dari total 78 subjek penelitian, didapatkan nilai tengah albumin 2,85 g/dL. Kelompok dengan albumin <2,85 g/dL memiliki skor CCI lebih tinggi dibandingkan kelompok dengan albumin ≥2,85 g/dL. Analisis menunjukkan hubungan bermakna secara signifikan antara status albumin dan komplikasi pascaoperasi (p<0,05).
Kesimpulan: Status pascaoperasi berhubungan signifikan dengan komplikasi pasca pembedahan saluran cerna. Penilaian albumin dapat digunakan untuk mengidentifikasi pasien berisiko tinggi komplikasi dan merencanakan intervensi nutrisi guna mengurangi komplikasi.
Background: Gastrointestinal surgery carries a high risk of complications, increasing morbidity, mortality, and healthcare costs. Postoperative albumin decline associated with systemic inflammation serves as an important indicator of complications. The Comprehensive Complication Index (CCI) is used to assess complications more comprehensively than the Clavien-Dindo Classification.
Methods: This prospective cohort study was conducted at RSUPN Cipto Mangunkusumo from July to November 2024. The study subjects were adult patients undergoing gastrointestinal surgery. Out of 80 initial subjects, 78 met the inclusion criteria, with 39 in the <2.85 g/dL albumin group and 39 in the >2.85 g/dL albumin group. Postoperative complications were measured using the Comprehensive Complication Index (CCI), which reflects all complications on a continuous scale from 0 to 100, with higher scores indicating greater complication burden. Bivariate analysis was performed using the Mann-Whitney test to compare CCI scores between the two albumin groups.
Results: Among the 78 subjects, the median albumin level was 2.85 g/dL. CCI score in the <2.85 g/dL albumin group significantly higher than the >2.85 g/dL albumin group. These findings indicate a significant association between albumin levels and postoperative complication (p<0.05)..
Conclusion: Postoperative albumin status is significantly associated with gastrointestinal surgery complications. Albumin assessment can be used to identify high-risk patients and plan nutritional interventions to reduce complications."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2025
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UI - Tugas Akhir  Universitas Indonesia Library
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Indah Sri Wulandari
Korelasi rasio C-Reactive protein terhadap albumin dengan delta appendicular skeletal muscle index pada pasien pembedahan saluran cerna mayor di RSUPN Cipto Mangunkusumo = Correlation between C-Reactive protein albumin ratio and delta appendicular skeletal muscle index in patients undergoing major gastrointestinal surgery
"Latar Belakang: Penyakit saluran pencernaan merupakan masalah kesehatan yang sering terjadi di seluruh dunia, pembedahan menjadi prosedur utama dalam penanganan tumor dan kanker saluran cerna. Tindakan pembedahan ini sering kali berisiko menimbulkan komplikasi, seperti penurunan massa otot rangka akibat peningkatan respon inflamasi. Rasio C-Reactive Protein (CRP) terhadap albumin dapat digunakan sebagai indikator penting dalam memprediksi prognosis dan komplikasi pasca operasi, termasuk inflamasi sistemik dan penurunan indeks massa otot rangka. Pengukuran rasio CRP terhadap albumin yang menilai status inflamasi dapat menggambarkan penurunan massa otot yang dinilai dengan perubahan Appendicular Skeletal Muscle Index (ASMI) pra dan pascaoperasi pada pasien yang menjalani pembedahan saluran cerna mayor.
Metode: Penelitian ini merupakan studi kohort prospektif pada pasien yang menjalani pembedahan saluran cerna mayor di RSUPN dr. Cipto Mangunkusumo. Dilakukan pengukuran kadar CRP dan albumin satu sampai tujuh hari praoperasi, kemudian hasil CRP dan albumin dibagi menjadi rasio CRP terhadap albumin. Pengukuran ASMI menggunakan Bioelectrical Impedance Analysis (BIA) seca® mBCA 525 yang dilakukan satu sampai tiga hari praoperasi dan lima sampai tujuh hari pascaoperasi. Karakteristik subjek lainnya meliputi usia, jenis kelamin, berat badan, tinggi badan, IMT, status gizi berdasarkan GLIM, etiologi pembedahan, penyakit penyerta, kadar CRP praoperasi, kadar albumin praoperasi, serta asupan energi dan protein praoperasi.
Hasil: Terdapat 78 subjek dengan rerata usia 52 tahun dan mayoritas perempuan (57,7%). Terdapat 60,3% status malnutrisi menurut kriteria GLIM, 32% subjek mengalami delta ASMI turun, asupan energi kurang sebanyak 48,7%, asupan protein kurang sebanyak 57,7%, dan nilai median rasio CRP terhadap albumin 5,98. Tidak terdapat korelasi rasio CRP terhadap albumin dengan delta ASMI (p = 0,424). Tidak terdapat perbedaan bermakan antara rasio CRP terhadap albumin dengan delta ASMI turun dan tidak turun (p = 0,813).
Kesimpulan: Tidak terdapat korelasi antara rasio CRP terhadap albumin dengan delta ASMI pada pasien yang menjalani pembedahan saluran cerna mayor. Tidak terdapat perbedaan bermakna antara rasio CRP terhadap albumin dengan delta ASMI turun dan tidak turun.
Background: Gastrointestinal diseases are prevalent health problems worldwide, with surgery being the primary procedure for treating tumors and gastrointestinal cancers. However, this surgical intervention often carries the risk of complications, such as a decline in skeletal muscle mass due to increased inflammatory responses. The C-Reactive Protein (CRP) albumin ratio can serve as a significant indicator for predicting prognosis and postoperative complications, including systemic inflammation and a decrease in skeletal muscle index. Measuring the CRP albumin ratio, which assesses inflammatory status, can reflect muscle mass reduction, evaluated through changes in Appendicular Skeletal Muscle Index (ASMI) before and after surgery in patients undergoing major gastrointestinal surgery.
Methods: This study is a prospective cohort conducted on patients undergoing major gastrointestinal surgery at Dr. Cipto Mangunkusumo National General Hospital. CRP and albumin levels were measured 1 to 7 days preoperatively, and the CRP to albumin ratio was calculated. ASMI was measured using Bioelectrical Impedance Analysis (BIA) seca® mBCA 525 within 1 to 3 days before surgery and 5 to 7 days postoperatively. Other subject characteristics included age, sex, body weight, height, BMI, nutritional status based on GLIM criteria, surgical etiology, comorbidities, preoperative CRP levels, preoperative albumin levels, and preoperative energy and protein intake.
Results: A total of 78 subjects with a mean age of 52 years were included, with the majority being female (57.7%). There were 60.3% of subjects with malnutrition status according to GLIM criteria, 32% experienced a decrease in delta ASMI, 48.7% had inadequate energy intake, 57.7% had insufficient protein intake, and the median CRP-to-albumin ratio was 5.98. There was no correlation between the CRP albumin ratio and delta ASMI (p = 0.424). There was also no significant difference between the CRP albumin ratio and decreased versus non- decreased delta ASMI (p = 0.813).
Conclusion: There was no correlation between the CRP albumin ratio and delta ASMI in patients undergoing major gastrointestinal surgery. Additionally, no significant difference was found between the CRP albumin ratio and decreased versus non-decreased delta ASMI."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tugas Akhir  Universitas Indonesia Library
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Retno Wijayanti
Korelasi antara perubahan kadar albumin dengan perubahan kekuatan genggam tangan pada pasien bedah saluran cerna = Correlation between delta albumin levels and changes in handgrip strength in patients undergoing gastrointestinal surgery
"Latar Belakang: Pembedahan saluran cerna dapat menurunkan kapasitas fungsional, terlihat dari penurunan kekuatan genggam tangan, yang berhubungan dengan malnutrisi dan inflamasi. Albumin adalah parameter nutrisi penting yang dapat memengaruhi kekuatan otot, tetapi hubungan antara perubahan kadar albumin dengan perubahan kekuatan genggam tangan pada pasien pasca bedah saluran cerna belum banyak diteliti.
Metode: Penelitian ini adalah studi kohort prospektif pada 52 pasien dewasa (19–65 tahun) yang menjalani pembedahan saluran cerna di RSUPN Dr. Cipto Mangunkusumo. Kadar albumin serum diukur sebelum dan setelah operasi, sementara kekuatan genggam tangan dinilai menggunakan dinamometer digital. Analisis korelasi Spearman digunakan untuk menilai hubungan antara perubahan kadar albumin dan kekuatan genggam tangan.
Hasil: Mayoritas subjek memiliki kekuatan genggam tangan praoperasi rendah, dengan rata-rata penurunan kekuatan genggam pascaoperasi sebesar 3,5 kg. Mayoritas pasien juga mengalami hipoalbuminemia pascaoperasi, dengan rerata penurunan kadar albumin 0,4 g/dL. Uji korelasi menunjukkan hubungan bermakna antara perubahan kadar albumin dan kekuatan genggam tangan pascaoperasi (r = 0,328; p = 0,018). Kesimpulan: Terdapat korelasi sedang yang signifikan antara perubahan kadar albumin dan perubahan kekuatan genggam tangan pada pasien pasca bedah saluran cerna.
Background: Gastrointestinal surgery can reduce functional capacity, evidenced by a decline in handgrip strength, which is associated with malnutrition and inflammation. Albumin is an essential nutritional parameter that can influence muscle strength, but the relationship between changes in serum albumin levels and handgrip strength in postoperative gastrointestinal surgery patients has not been extensively studied. Methods: This study is a prospective cohort involving 52 adult patients (aged 19–65 years) who underwent gastrointestinal surgery at Dr. Cipto Mangunkusumo National General Hospital. Serum albumin levels were measured preoperatively and postoperatively, while handgrip strength was assessed using a digital dynamometer. Spearman correlation analysis was used to evaluate the relationship between changes in serum albumin levels and handgrip strength.
Results: The majority of subjects had low preoperative handgrip strength, with an average decrease in postoperative handgrip strength of 3.5 kg. Most patients also experienced postoperative hypoalbuminemia, with an average albumin level reduction of 0.4 g/dL. Correlation analysis revealed a significant moderate association between changes in serum albumin levels and handgrip strength (r = 0,328; p = 0,018). Conclusion: There is a significant moderate correlation between changes in serum albumin levels and changes in handgrip strength in postoperative gastrointestinal surgery patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2025
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UI - Tugas Akhir  Universitas Indonesia Library
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Oktaviati
Diameter draining vena pasca operasi minggu pertama sebagai prediktor maturasi arteriovenous fistula avf = First week postoperative draining vein diameter as a predictor of arteriovenous fistula maturation avf
"[ABSTRAK
Pendahuluan Masalah utama pada ArterioVenous Fistula AVF adalah kegagalan maturasi Deteksi dini bahwa AVF akan mengalami gagal maturasi dibutuhkan sehingga memungkinkan untuk melakukan revisi atau membuat akses vaskular yang baru sesegera mungkin Diameter vena pra operasi adalah faktor prediktor independen dalam maturasi Tujuan penelitian ini adalah untuk mengetahui prediksi dini maturasi AVF berdasarkan peningkatan ukuran diameter draining vein pasca operasi minggu pertama Metode Penelitian dilakukan secara kohort retrospektif dengan mengambil data rekam medis pasien yang menjalani operasi pembuatan AVF di RSCM tahun 2013 2014 Diameter vena pra operasi dan diameter draining vein pasca operasi minggu pertama diukur dengan USG Doppler Peningkatan diameter draining vein pasca operasi minggu pertama dihubungkan dengan maturasi AVF Hasil Didapatkan 38 pasien dengan angka maturasi 81 6 Tidak didapatkan perbedaan maturasi yang bermakna pada usia jenis kelamin diabetes melitus hipertensi CHF CAD stroke hepatitis hiperlipidemia riwayat dilakukan AVF operator dan diameter arteri pra operasi Terdapat perbedaan yang bermakna pada AVF jenis radiosefalika dan brakiosefalika p 0 022 Didapatkan perbedaan maturasi yang bermakna pada diameter draining vein pasca operasi minggu pertama dan peningkatannya pada AVF tipe brakiosefalika p 0 034 dan p 0 041 dan radiosefalika p 0 012 dan p 0 011 Nilai cut off peningkatan diameter draining vein pasca operasi minggu pertama untuk batasan prediksi maturasi adalah 0 65 mm dengan sensitifitas sebesar 90 3 spesifisitas sebesar 85 7 Pada AVF tipe brakiosefalika nilai cut off adalah 0 45 mm dengan sensitifitas sebesar 95 8 spesifisitas sebesar 100 Pada AVF tipe radiosefalika nilai cut off adalah 1 00 mm dengan sensitifitas sebesar 85 7 spesifisitas sebesar 100 Simpulan Peningkatan diameter draining vein pasca operasi minggu pertama dapat dijadikan sebagai prediktor maturasi AVF ABSTRACT Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ;Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation , Introduction The main problem in ArterioVenous Fistula AVF is the failure of maturation Early detection for non mature AVF is needed making it possible to revise or create a new vascular access as soon as possible Preoperative vein diameter is considered to be an independent predictor factor in the maturation The purpose of this study was determining the early prediction of AVF maturation using the enlargement of draining vein diameter in the first week postoperative Methods Design of this study was cohort retrospective by taking patients medical records who underwent AVF surgery Vein diameter were measured preoperative and first week postoperative with Doppler ultrasound The enlargement of the first week draining vein diameter was associated with AVF maturation Results There was 38 patients with maturation rate was 81 6 There were no significant maturation differences on age sex diabetes mellitus hypertension CHF CAD stroke hepatitis hyperlipidemia AVF history operator and preoperative arterial diameter There was significant maturation difference in the radiocephalica and brachiocephalica AVF type p 0 022 There were significant maturation difference in first week postoperative draining vein diameter and it s increasement in brachiocephalica type p 0 034 and p 0 041 and radiocephalica type p 0 012 and p 0 011 Cut off value for first week postoperative draining vein diameter increasement in maturation prediction limitation is 0 65 mm with a sensitivity of 90 3 specificity of 85 7 For brachiocephalica type cut off value is 0 45 mm with a sensitivity of 95 8 specificity of 100 For radiocephalica type cut off value is 1 00 mm with a sensitivity of 85 7 specificity of 100 Conclusion First week postoperative draining vein diameter increasement can be used as predictors of AVF maturation ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Matulessy, Theo Adelberth
Pengaruh tingkat pendidikan terhadap angka kejadian postoperative cognitive dysfunction (POCD) pasien lanjut usia yang menjalani anestesia umum = Effect of educational levels on the incidence of postoperative cognitive dysfunction (POCD) in elderly patient undergoing general anesthesia
"ABSTRAK
Latar belakang: Postoperative Cognitive dysfunction (POCD) adalah gangguan
fungsi kognitif dan komplikasi yang sering ditemukan pada pasien usia lanjut pasca
menjalani anestesia umum. Selain faktor usia, pembedahan mayor, penyakit
penyerta dan riwayat konsumi obat-obatan tertentu, salah satu faktor dalam
peningkatan kejadian POCD adalah tingkat pendidikan pasien. Penelitian tentang
tingkat pendidikan dengan angka insiden POCD masih menunjukkan hasil yang
berbeda-beda. Kondisi demografis Indonesia mengalami peningkatan populasi
lanjut usia disertai tingkat pendidikan yang masih rendah sehingga penelitian ini
bertujuan untuk mengetahui pengaruh tingkat pendidikan terhadap angka kejadian
POCD pada populasi usia lanjut.
Metode. Penelitian ini merupakan uji potong lintang terhadap pasien lanjut usia ( lebih dari
60 tahun) yang menjalani pembiusan umum di RSCM pada bulan Februari sampai
Desember 2018. Sebanyak 84 subyek diambil setelah memenuhi kriteria inklusi.
Skor kognitif dinilai menggunakan Trail making test B dan Digit Span Backward.
Analisis data menggunakan uji bivariat dengan Chi-Square dan analisis multivariat
regresi logistik.
Hasil. Jumlah subjek yang dianalisis pada penelitian ini 80 subjek dengan 9
(11.8%) pasien dengan pendidikan rendah, 41 (52.6%) pasien dengan pendidikan
menengah dan 30 (35.6%) pasien dengan pendidikan tinggi. Angka kejadian POCD
sebesar 20 (25%) dengan tingkat pendidikan rendah sebanyak 2 (22.2%), tingkat
pendidikan menengah sebanyak 11 (26.8%) dan tingkat pendidikan tinggi sebanyak
7 (23.3%). Pengaruh tingkat pendidikan terhadap angka kejadian POCD tidak
bermakna dengan p 0.921 dan memiliki OR sebesar 1.124. Pada penelitian ini usia
tidak bermakna menyebabkan POCD (p=0.064), jenis kelamin tidak bermakna
menyebabkan POCD (p=0.242), dan riwayat operasi tidak bermakna menyebabkan
POCD (p=0.196).
Simpulan. Tingkat pendidikan tidak mempengaruhi angka kejadian POCD pada
pasien lanjut usia yang menjalani anestesia umum.
ABSTRACT
Background: Cognitive impairment after anesthesia and surgery, also known as
Postoperative Cognitive dysfunction (POCD) are most commonly found amongst
the elderly population. Factors that elevate the risk of POCD include old age, major
surgery, pre-existing comorbidities and consumption of certain drugs. Another
factor known to increase the incidence of POCD is low education level.
However,study about education level and the incidence of POCD still have different
results. As Indonesias elderly population and low level education dominance are
expected to increase, this study aims to evaluate the association of educational level
and the incidence of POCD amongst the elderly population after general anesthesia.
Method: This study is a cross-sectional study involving elderly patients ( 60
years) who underwent general anesthesia at RSCM during February to December
2018. A total of 84 subjects were selected after fulfilling the inclusion criteria.
Cognitive score was assessed using Trail making test B and Digit Span Backward,
while psychometric test was carried out by a validated psychologist. Data were
analyzed using bivariate analysis test with Chi-Square and multivariate analysis
with logistic regretion.
Results: Demographic studies grouped 9 (11.8%) patients with low education, 41
(52.6%) patients with secondary education and 30 (35.6%) patients with higher
education. The incidence of POCD was 25% and incidence od POCD in group with
low level of education was 2 (22.2%), average level of education and POCD was
11 (26.8%) and the higher level of education and POCD were 7 (23.3%). This study
found no significant association between education level and the incidence of
POCD (p=0.921), with an odds ratio of 1.124. Furthermore, this study found that
no significant association between age with the incidence of POCD (p=0.064) nor
does gender and incidence of POCD (p=0.242), and history of surgery with
incidence of POCD (p=0.196
Conclusion: Education level do not affect the incidence of POCD in elderly
patients undergoing general anesthesia."
2018
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Korenkov, Michael, editor
Bariatric surgery : technical variations and complications
"The increasing prevalence of obesity in many countries means that it should now be considered a pandemic. It is widely recognized that obesity increases the risk of a variety of life-threatening conditions, including heart disease, diabetes, and hypertension. Bariatric surgery is often the most effective way to treat such morbid obesity. Nevertheless, while various bariatric procedures have been proposed, to date standards have been lacking. In this book, leading experts from around the world discuss all aspects of bariatric surgery and present their own favored versions of surgical procedures with the aid of informative illustrations. Technical nuances are carefully described, and detailed attention is devoted to potential complications and how to avoid them. "
Berlin: Springer-Verlag, 2012
e20420784
eBooks  Universitas Indonesia Library
cover
Complications in foot surgery : prevention and management
Baltimore: The Williams & Wilkins, 1976
617.585 COM
Buku Teks SO  Universitas Indonesia Library
cover
Beta Novianti Kusuma Ningrum
Hubungan Kadar Albumin saat Admisi dengan Gastrointestinal Dysfunction Score pada Pasien Sakit Kritis = Association Between Albumin Levels at Admission with Gastrointestinal Dysfunction Score in Critically Ill Patients
"Latar Belakang: Disfungsi saluran cerna berhubungan dengan luaran klinis yang lebih buruk pada pasien sakit kritis. Kadar albumin serum yang rendah merupakan salah satu faktor yang dapat meningkatkan risiko disfungsi saluran cerna. Hubungan kadar albumin dengan disfungsi saluran cerna masih inkonklusif karena pendekatan diagnostik disfungsi saluran cerna yang belum terstandarisasi dengan baik. Gastrointestinal dysfunction score (GIDS) instrumen dengan subjektivitas minimal dan reproduktifitas maksimal, diharapkan dapat menegakkan diagnosis disfungsi saluran cerna dengan objektivitas yang lebih baik. Penelitian ini dilakukan untuk mengetahui hubungan antara kadar albumin saat admisi dengan terjadinya disfungsi saluran cerna yang dinilai menggunakan GIDS. Metode: Penelitian ini merupakan penelitian kohort prospektif pada subjek berusia ≥18 tahun yang dirawat di ruang rawat intensif Rumah Sakit Umum Pusat Nasional (RSUPN) dr. Cipto Mangunkusumo dan Rumah Sakit Universitas Indonesia (RSUI). Karakteristik subjek penelitian berupa usia, jenis kelamin, status gizi, penyakit komorbid, diagnosis admisi intensive care unit (ICU), waktu inisiasi pemberian nutrisi oral atau enteral, kebiasaan mengonsumsi alkohol, dan skor sequential organ failure assessment (SOFA). Dilakukan analisis bivariat untuk menilai hubungan kadar albumin saat admisi dengan disfungsi saluran cerna. Hasil: Diperoleh 64 subjek, kelompok kadar albumin rendah 32 subjek dan kelompok kadar albumin normal 32 subjek. Rerata usia subjek 50,2±15,7, laki-laki 64,1%, 26,6% subjek dengan status gizi berat badan normal berdasarkan indeks massa tubuh (IMT), 50% subjek dengan malnutrisi secara klinis,  21,9% subjek dengan diagnosis komorbid diabetes melitus dan 3,1% subjek dengan parkinson, 34,4 % subjek dengan diagnosis admisi bedah, 95,3% subjek mendapatkan nutrisi oral atau enteral ≤ 48 jam, median skor SOFA 3 (0-12). Rerata kadar albumin  subjek dengan disfungsi saluran cerna 2,7±0,6 g/dL, rerata kadar albumin  subjek tidak disfungsi saluran cerna 3,7±0,7 g/dL. 31,3% subjek mengalami disfungsi saluran cerna. Terdapat hubungan signifikan secara statistik antara kadar albumin saat admisi dengan disfungsi saluran cerna RR 9 (95%CI 2,3-35,6; p <0,001) dan skor GIDS, p<0,001. Kesimpulan: Terdapat hubungan bermakna antara kadar albumin saat admisi dengan disfungsi saluran cerna. Pemeriksaan kadar albumin saat admisi ICU idealnya dilakukan secara rutin dan diikuti dengan koreksi kadar albumin apabila ditemukan kondisi hipoalbuminemia.
Background: Gastrointestinal dysfunction is associated with worse clinical outcomes in critically ill patients. Low serum albumin levels are one factor that can increase the risk of gastrointestinal dysfunction. The relationship between albumin levels and gastrointestinal dysfunction is still inconclusive because the diagnostic approach to gastrointestinal dysfunction is not yet well standardized. Gastrointestinal dysfunction score (GIDS) is an instrument with minimal subjectivity and maximum reproducibility, which is expected to provide a diagnosis of gastrointestinal dysfunction with better objectivity. This research was conducted to determine the relationship between albumin levels at admission and the occurrence of gastrointestinal dysfunction as assessed using GIDS. Methods: This study is a prospective cohort study of subjects aged ≥18 years who were treated in the intensive care unit at RSUPN dr. Cipto Mangunkusumo and RSUI. Characteristics of research subjects included age, gender, nutritional status, comorbid diseases, ICU admission diagnosis, time of initiation of oral or enteral nutrition, alcohol consumption habits, and SOFA score. Bivariate analysis was carried out to assess the relationship between albumin levels at admission and gastrointestinal dysfunction. Results: There were 64 subjects, 32 subjects in the low albumin level group and 32 subjects in the normal albumin level group. Mean age of subjects 50.2 ± 15.7, 64.1% male, 26.6% subjects with normal weight nutritional status based on BMI, 50% subjects with clinical malnutrition, 21.9% subjects with comorbid diagnosis of diabetes mellitus and 3.1%  subjects with Parkinson's, 34.4%  subjects with surgical admission diagnosis, 95.3% subjects received oral or enteral nutrition ≤ 48 hours, median SOFA score 3 ( 0-12). The mean albumin level of subjects with gastrointestinal dysfunction was 2.7 ± 0.6 g/dL, the mean albumin level of subjects without gastrointestinal dysfunction was 3.7 ± 0.7 g/dL. 31.3% of subjects experienced gastrointestinal dysfunction. There was a statistically significant relationship between albumin levels at admission and gastrointestinal dysfunction RR 9 (95%CI 2.3-35.6; p <0.001) and GIDS score, p<0.001. Conclusion: There is a significant relationship between albumin levels at admission and gastrointestinal dysfunction. Albumin levels examination during ICU admission should ideally be carried out routinely and followed by correction of albumin levels if hypoalbuminemia is found."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tugas Akhir  Universitas Indonesia Library
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Lina Virfa
Gambaran Indikator Keberhasilan Ekstubasi Pada Pasien Post Operasi di Ruang Perawatan Intensif Rumah Sakit Dr.Ciptomangunkusumo Jakarta = An Overview of Indicators of Extubation Success in Postoperative Patients in the Intensive Care Room of Dr. Ciptomangunkusumo Hospital Jakarta.
"Pasien yang menjalani prosedur pembedahan secara elektif dilakukan pembiusan umum dan tindakan intubasi serta menggunakan ventalisi mekanik. Ketika pasien dinilai sudah baik dan mampu dalam bernafas secara spontan, pengunaan ETT harus segera  di lepaskan. Menyegerakan ekstubasi pada pasien dengan pasca pembedahan merupakan hal yang penting dilakukan agar tidak terjadi komplikasi yang cukup besar. Durasi intubasi yang lebih lama  insiden komplikasi akan lebih tinggi, termasuk kejadian pneumonia terkait ventilator (VAP), dan peningkatan kematian. Penelitian ini bertujuan untuk mengetahui gambaran indikator  keberhasilan ekstubasi bedasarkan karakteristik fisik dan psikologis pada pasien post operasi di ruang perawatan intensif. Penelitain ini menggunakan desain deskriptif murni dengan pendekatan retospektif melalui data sekunder pada 96 responden. Pengambilan sampel dilakukan dengan teknik stratifed random sampling. Instrumen yang digunakan adalah lembar cheklist penilaian ekstubasi. Hasil penelitian didapatkan bahwa 100% pasien post operasi dilakukan ekstubasi dengan status kesadaran compos mentis atau nilai GCS > 10, hemodinamik stabil dengan nilai mean teakanan darah sistolik 120,7mmhg, nilai AGD denagn nilai mean PO2 120, PCo2 39.99 dan SaO2 98.36%, memiliki nilai hemtokrit normal denagn nilai mean Hct 38,98%, telah dilakukan spontaneous breathing trial dan kooperatif. 96% pasien memiliki refleks batuk yang kuat sebelum dialakukan ekstubasi.

Kata kunci : Ekstubasi, pasca pembedahan, penilaian ekstubasi

Patients undergoing elective surgical procedures are subjected to general anesthesia and intubation procedures and use mechanical ventalization. When the patient is judged to be good and able to breathe spontaneously, the use of ETT must be released immediately. Moving extubation in patients with post-surgery is important to do so that there are no major complications.  A longer incidence of intubation will be higher, including the incidence of ventilator-related pneumonia (VAP), and increased mortality.   This study aims to determine the description of indicators of extubation success based on physical and psychological characteristics in postoperative patients in intensive care rooms.  This research used a purely descriptive design with a retospective approach through secondary data on 96 respondents. Sampling was carried out using a stratifed random sampling technique. The instrument used is an extubation assessment cheklist sheet. The results of the study found that 100% of postoperative patients were extubated with compos mentis awareness status or GCS value > 10, stable hemodynamics with a mean value of systolic blood teakanan 120.7mmhg, AGD  value with mean PO2 value 120, PCo2 39.99 and SaO2 98.36%, had a normal hemtokrit value with a mean Hct value of 38.98%, spontaneous breathing trial and cooperative. 96% of patients have a strong cough reflex before  he performed extubation."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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