Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Pendahuluan: Skor TRISS menjadi salah satu alat yang paling umum digunakan mengukur keberhasilan pelayanan trauma. Saat ini belum ada data penggunaan Skor TRISS pada penanganan pasien politrauma di Instalasi Gawat Darurat (IGD) Rumah Sakit Cipto Mangunkusumo (RSCM). Penelitian ini disusun untuk mengetahui kemampuan skor TRISS memprediksi kematian pasien politrauma di IGD RSCM. Metode Penelitian: Penelitian ini adalah penelitian kohor retrospektif. Data diambil dari rekam medis pasien politrauma tahun 2011- 2014 yang datang di IGD RSCM. Analisis dilakukan untuk mengetahui hubungan skor TRISS dengan prognosis pasien. Dilakukan analisa bivariat dan multivariat dengan menggunakan program SPSS 18. Temuan Penelitian dan Diskusi: Terdapat 70 data pasien yang memenuhi inklusi pada pasien ini. Mayoritas pasien adalah laki-laki (65%) dan berusia muda. Terdapat 69 pasien yang mengalami trauma tumpul dengan kecelakaan lalu lintas menjadi penyebab terbanyak trauma paling banyak(94,3%). Sebanyak 26 pasien meninggal dunia dan 54 pasien survive setelah mendapat perawatan. Pada analisis bivariat dan multivariat didapatkan hubungan bermakna antara skor TRISS dengan prognosis pasien. Skor TRISS mampu memprediksi kuat mortalitas pasien politrauma (AUC = 0,899; IK95% 0,824-0,975). Skor TRISS mempunyai sensivitas 84,6% dan spesifivitas 81,8 % dengan titik potong optimal ≤90,5. Simpulan: Skor TRISS dapat memprediksi kematian pasien politrauma yang di rawat di RSCM. ...... Introduction: TRISS score is one of the most commonly used trauma score. Currently there is no data about using TRISS score in the care of polytrauma patients at emergency department of Ciptomangunkusumo Hospital. This research is to determine whether TRISS score can predict the mortality of polytrauma patients at Ciptomangunkusumo Hospital. Methods: It was a retrospective cohort study. Data was collected from medical records of polytrauma patients who was admitted to emergency department of Ciptomangunkusumo Hospital 2011-2014. From there, we analyze the relationship between TRISS score and patient?s prognosis. Furthermore, we conducted bivariate and multivariate analysis by SPSS 18 software. Result and Discussion: Seventy medical records was included in this study. Majority of our patients was male (65%) in young age. There were 69 patients who experienced blunt trauma, with the majority of them (94,3%) was caused by motor vehicle accident. After receiving trauma care, there were 26 deaths, while other 54 patients survived. From bivariate and multivariate analysis, we found a significant association between TRISS score and patient?s prognosis. TRISS score strongly predicts polytrauma patient?s mortality (AUC 0,899; IK95% 0,824-0,975). TRISS score has 84,6% sensitivity and 81.8% specificity with optimal intersection point ≤90,5. Conclusion: TRISS score can predict the mortality of polytrauma patients at Ciptomangunkusumo Hospital.

Abstrak :
Pendahuluan Berbagai studi menunjukkan obat off-label banyak diberikan pada pasien anak. Pemberian obat off-label dapat menimngkatkan risiko efek samping obat. Penelitian ini bertujuan mengevaluasi peresepan obat off-label pada pasien anak di Instalasi Gawat Darurat RSUPN dr. Cipto Mangunkusumo (IGD-RSCM) yang selama ini belum pernah diteliti. Metode Desain penelitian ini potong lintnag. Sampel peresepan, diambil dari rekam medis pasien anak di IGD-RSCM secara consecutive sampling. Kriteria inklusi adalah peresepan untuk pasien anak usia 0-18 tahun di IGD RSCM pada periode Januari- Desember 2018. Kriteria eksklusi berupa data tidak terbaca atau tidak lengkap, peresepan elektrolit, suplemen, vitamin, dan obat luar. Data jenis kelamin, usia, dan jenis kelompok obat berdasarkan klasifikasi The Anatomical Therapeutic Chemical (ATC) dicatat. Status peresepan off-label ditentukan berdasarkan usia pasien saat obat diresepkan. Proporsi peresepan off-label pada kelompok gender dan usia anak dianalisis dengan uji Chi-Square. Hasil Dari 446 sampel peresepan yang diuji, 24,7% sampel merupakan peresepan off- label berdasarkan kategori usia.Berdasarkan kelompok ATC, kelompok obat yang paling sering diresepkan adalah obat sistem saraf dengan proposi off-label paling tinggi ditemukan pada kelompok agen antineoplastik dan imunomodulasi (88,2%). Tidak ada perbedaan proporsi peroff-label yang signifikan antara pasien anak laki- laki (21,9%) dan perempuan (27,4%) (p = 0,169, PR= 0,662 IK= 0,593 – 1,005). Tidak ada hubungan signfikan antara kelompok usia (bayi, anak, dan remaja) terhadap proporsi peresepan off-label (p = 0,086). Kesimpulan Proporsi peresepan obat off-label pasien anak di Instalasi Gawat Darurat RSCM adalah 24,7%. Jenis kelamin dan perbedaan kelompok usia antara bayi, anak, dan remaja tidak berhubungan dengan besar proporsi peresepan off-label. ......Introduction Various studies showed that pediatric patients often received off-label drugs. Off- label drug administration can increase the risk of adverse drug reactions. This study aims to evaluate the off-label prescriptions in pediatric patients at the Emergency Department of dr. Cipto Mangunkusumo Hospital (IGD-RSCM) which has never been studied. Methods This is a cross sectional study. Prescription samples were taken from the medical records at IGD-RSCM by consecutive sampling. The inclusion criteria were prescriptions for children aged 0-18 years treated at IGD-RSCM during January- December 2018. The exclusion criteria were unreadable, incomplete prescribing data, electrolytes, supplements, vitamins, and external medications. Data of gender, age, and drug class based on The Anatomical Therapeutic Chemical (ATC) classification were recorded. Off-label prescribing status was determined based on the patient's age at the time of prescription. Proportions of Off-label prescriptions in each gender and pediatric age groups were analyzed using the Chi-Square test. Results Of the 446 prescriptions analyzed , 24.7% were prescribed off-labelly by age category. Based on the ATC, nervous system drugs was the most frequently prescribed medication. The highest proportion of off-label drugs prescription was the antineoplastic and immunomodulating agent (88.2%). There was no significant difference in the off-label prescription proportion between boys (21.9%) and girls (27.4%) (p=0.169, PR=0.662 CI=0.593-1.005). There was no significant association between age groups (infants, children and adolescents) and the proportion of off-label prescriptions (p= 0.086). Conclusion The proportion of pediatric off-label prescription at the IGD-RSCM was 24.7%. Gender and pediatric age group differences were not associated with the level of off-label prescriptions proportions.