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Amanda Soebadi

Faktor Risiko Kardiovaskular pada Anak Usia 9-12 Tahun dan Faktor-Faktor yang Memengaruhi dengan Perhatian Khusus pada Berat Lahir = Cardiovascular Risk Factors in Children 9-12 Year Old and Influencing Factors With Specific Attention to Birth Weight

"Latar belakang. Faktor risiko PJK dapat terjadi sejak masa kanak-kanak dan dapat dicegah. Gangguan pertumbuhan intrauterin dapat meningkatkan kemungkinan timbulnya faktor risiko PJK. Penelitian sebelum11Ya menunjukkan hasil yang tidak konsisten. Hanya satu penelitian serupa yang pernah dilaporkan di Indonesia. Tujuan. Mengidentifik.asi faktor-faktor risiko kardiovaskular pada anak usia 9-12 tahun dan mengetahui faktor-faktor yang memengaruhinya, dengan perhatian khusus pada berat lahir. Metode. Studi potong lintang dilakukan pada anak usia 9-12 tahun di 4 sekolah dasar di Jakarta Pusat. Berat lahir didapatkan dari catatan kelahiran yang dimiliki orangtua. Pada subjek dilakukan pemeriksaan fisis dan antropometris, pengukuran massa lemak tubuh, dan pengambilan darah vena untuk pemeriksaan glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida. Pada subjek dilakukan juga analisis diet dengan metode three-day food recall dan penilaian tingkat aktivitas fisis dengan Physical Activity Questionnaire for Children (PAQ-C). Orangtua diminta mengisi kuesioner mengenai riwayat pemberian ASI dan kondisi sosioekonomi. Proporsi obesitas, hipertensi, glukosa puasa terganggu, dan dislipidemia ditentukan. Koefisien korelasi antara berat lahir dengan indeks massa tubuh (IMT), tekanan darah sistolik, tekanan darah diastolik, massa lemak tubuh., glukosa puasa, kolesterol total, HDL, LDL, dan trigliserida ditentukan dengan uji Spearman. Korelasi yang bermakna diuji dengan analisis multivariat dengan mengikutsertakan faktor kovariat durasi pembcrian ASI, durasi ASI eksklusif, asupan nutrisi, tingkat aktivitas fisis, dan penghasilan keluarga. · Hasil. Didapatkan 85 subjek, 49 (57,6%) perempuan. Median (rentang) berat lahir subjek 3000 (1500-4300) g; 6 (7,1%) subjek memiliki berat lahir <2500 g. Proporsi obesitas, hipertensi sistolik, hipertensi diastolik, glukosa puasa terganggu, dan dislipidemia berturut-turut 10,6%; 2,4%; 4%; 2,4%; dan 31,8%. Terdapat korehsi lemah yang bermakna secara statistika antara berat lahir dengan z-swre IMT (p=0,265; p=O,Ol4) dan persentil massa lemak tubuh (p=0,216; p=0,047). Tidak. ditemukan korelasi yang bermakna secara statistika antara berat lahir dengan variabel-variabel lainnya. Fak.tor kovariat yang memenuhi syarat untuk analisis multivariat adalah durasi total pemberian ASI, durasi ASI eksklusif, persentase asupan protein terhadap AKG, dan penghasilan keluarga. Pada regresi linear multipel, berat lahir masih berpengaruh terhadap z-score IMT (P=O,OOl; p=0,008) dan persentil massa lemak. tubuh (p=0,017; p=0,043) pada usia 9-12 tahun. Sim.pulan. Terdapat korelasi positif lemah yang bermak.na secara statistika antara berat lahir dengan IMT dan massa lemak. tubuh. Pengaruh berat lahir terhadap IMT dan massa lemak. tubuh tetap bermak.na apabila faktor pemberian ASI, asupan nutrisi, dan penghasilan keluarga diperhitungkan. Diperlukan penelitian kohort prospektif dengan memperhitungkan usia gestasi untuk menentukan dengan lebih tepat pengaruh berat lahir rendah, khususnya perturnbuhanjanin terganggu, terhadap faktor risiko kardiovaskular.

Background. Risk factors of CHD may develop since childhood and are preventable. Intrauterine growth disturbance leads to programming of metabolic and endocrine systems, causing CHD risk factors to arise. Previous studies have shown inconsistent results. Only one such study has been reported in Indonesia Objectives. To identify cardiovascular risk factors in children 9-12 years old and their influencing factors, with specific attention to bi.rth weight. Methods. A cross-sectional study was done in 9-12-year-old children from 4 elementary schools in Central Jakarta. Birth weight was obtained from birth records submitted by parents. Physical examination, anthropometric measurement, determination of body fat percentage, and venous blood sampling were done to determine fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Dietary analysis was done by a three-day food recall. Subjects' physical activity level was assessed using the Physical Activity Questionnaire for Children (P AQ-C). Parents completed a questionnaire regarding breastfeeding history and socioeconomic conditions. The proportions of obesity, hypertension, impaired fasting glucose, and dyslipidernia were calculated. The Spearman test was done to determine the correlation between birth weight and body mass index (BMI), systolic and diastolic blood pressure, body fat percentage, fasting blood glucose, total cholesterol, HDL, LDL, and triglycerides. Significant correlations were subjected to multivariate analysis incorporating total breastfeeding duration, exclusive breastfeeding duration, nutritional intake, physical activity level, and family income. Results. We obtained 85 subjects, 49 (57,6%) of which were female. Median (range) birth weight was 3000 (1500-4300) g; 6 (7,1%) had birth weight of <2500 g. The proportion of obesity, systolic hypertension, diastolic hypertension, impaired fasting glucose, and dyslipidemia was 10,6%; 2,4%; 4%; 2,4%; and 31,8%, respectively. A weak positive correlation was obtained between birth weight and BMI z-score (p=0,265; p=0,014); and between birth weight and body fat percentile (p=0,216; p=0,047). There was no statistically significant correlation between birth .veight and other variables. Covariates fulfilling significance criteria were total breastfeeding duration, exclusive breastfeeding duration, percentage protein intake to the local RDA, and family income. On multiple linear regression analysis, birth weight was still significantly related to BMI z-score (~=0,001; p=0,008) and body fat percentile (~=0,017; p=0,043) at 9-12 years of age when the covariates were considered. Conclusions. Birth weight is weakly and positively correlated with BMI and body fat percentage. The influence of birth weight on BMI and body fat percentage remains significant when breastfeeding history, nutritional intake, and family income are considered. A prospective cohort study incorporating gestational age is needed to determine the influence of low birth weight, particularly due to intrauterine growth disturbance, on cardiovascular risk factors."

Jakarta: Fakultas Kedokteran Universitas Indonesia , 2011

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Rita Mey Rina

Peran asam ursodeoksikolat terhadap kolestasis terkait sepsis pada neonatus = The role of ursodeoxycholic acid in neonate with sepsis associated cholestasis / Rita Mey Rina

" ABSTRAK

Latar belakang. Sepsis masih menjadi masalah di bidang neonatalogi sampai saat ini karena

dapat meningkatkan mortalitas dan morbiditas. Kolestasis merupakan salah satu morbiditas

yang terjadi selama sepsis. Angka kematian dan lama perawatan di rumah sakit akan

meningkat pada sepsis neonatorum yang disertai kolestasis. Asam ursodeoksikolat (AUDK)

dilaporkan dapat memperbaiki luaran kolestasis pada dewasa dan anak. Penelitian mengenai

manfaat AUDK pada neonatus masih terbatas, sampai saat ini belum ada penelitian tentang

manfaat AUDK pada kolestasis terkait sepsis (KTS).

Tujuan. Mengetahui pengaruh AUDK terhadap penurunan parameter fungsi hati (bilirubin

total/direk/indirek, AST, ALT, GGT), angka kematian, dan lama rawat neonatus dengan

KTS.

Metode. Penelitian ini merupakan uji klinis acak tersamar ganda yang dilakukan di Divisi

Neonatologi Departemen IKA FKUI-RSCM dari Januari - Oktober 2012. Neonatus yang

memenuhi kriteria inklusi dibagi secara random menjadi 2 kelompok (AUDK atau plasebo).

Asam ursodeoksikolat diberikan 30 mg/kgBB/hari dibagi 3 dosis selama 7 hari. Parameter

fungsi hati di evaluasi setelah 7 hari pengobatan. Luaran utama adalah penurunan nilai

bilirubin total/direk/indirek, AST, ALT, dan GGT. Luaran tambahan adalah angka kematian

dan lama rawat. Analisis statistik untuk luaran utama dan lama rawat dilakukan dengan uji

t/uji Mann-Whitney. Perbedaan kematian di analisis dengan uji x2 dan perbedaan survival

dengan metode Kaplan Meier.

Hasil : Penelitian dilakukan pada 37 subjek, 19 subjek pada kelompok AUDK dan 18 subjek

pada kelompok plasebo. Perbedaan perubahan parameter fungsi hati antara kelompok AUDK

dan kelompok plasebo tidak bermakna [bilirubin total (2,2 ± 2,9 vs 1,7 ± 4,6; p= 0,080),

bilirubin direk (1,1 ± 2,3 vs 0,6 ± 3,6; p= 0,080), bilirubin indirek [0,4 (0,1-5,6) vs 0,9 (0,1-

4,1); p= 0,358], ALT (0,5 [(-80,0) – (21,0)] vs -2,0 [(-167,0) – (85,0)]; p= 0,730), AST (43,0

(14,0-297,0) vs 150,0 (24,0-840,0); p= 0,081), and GGT (125,0 (48,0-481,0) vs 235,0 (56,0-

456,0); p= 0,108)], tetapi perubahan nilai bilirubin total, bilirubin direk, dan AST cenderung

lebih baik pada kelompok AUDK. Penurunan nilai bilirubin total terjadi pada 85,7% subjek

kelompok AUDK dan 64,3% pada kelompok plasebo. Nilai bilirubin direk menurun pada

78,6% subjek kelompok AUDK dan 64,3% subjek kelompok plasebo. Penurunan nilai AST

terdapat pada 57% subjek kelompok AUDK dengan penurunan terbesar 72 U/L, sedangkan

pada kelompok plasebo 57% subjek mengalami peningkatan nilai AST dengan peningkatan

tertinggi 473 U/L. Kematian terjadi pada 10,5% subjek di kelompok AUDK dan 27,7% di

kelompok plasebo (p=0,232). Dari analisis kesintasan tidak terdapat perbedaan survival

antara kedua kelompok. Tidak terdapat perbedaan rentang waktu lama rawat antara

kelompok AUDK (15-70) hari dan kelompok plasebo (10-88) hari (p=0,148).

Simpulan : Pemberian AUDK 30 mg/kg/hari selama 7 hari cenderung menurunkan nilai

bilirubin total, bilirubin direk, AST, serta angka kematian meskipun secara statistik tidak

terbukti bermakna. Hal ini masih mungkin disebabkan oleh power yang kurang pada

penelitian ini. Penelitian ulang perlu dilakukan dengan jumlah sampel yang lebih besar dan

durasi pemberian AUDK yang lebih panjang.

<ABSTRACT

Background. Sepsis is still an important issue in Neonatology field since it is related with

high mortality and morbidity. Cholestasis is one of the morbidities that related with sepsis.

Mortality and length of hospital stay will be increased in neonatal sepsis that associated with

cholestasis. Efficacy of ursodeoxycholic acid (UDCA) in cholestasis has been reported from

adult and pediatric population, however there is no publication regarding the efficacy of this

drug in neonates with sepsis associated cholestasis.

Objectives. To investigate the role of UDCA in liver function parameter (total, direct,

indirect bilirubin, AST, ALT, GGT), mortality, and length of hospital stay in neonates with

sepsis associated cholestasis.

Methods. A randomized controlled trial were done in Neonatology Division, Pediatric

Department, Cipto Mangunkusumo Hospital from January to October 2012. Neonates that

fulfilled the inclusion criteria, randomized into UDCA group and placebo group. We gave

ursodeoxycholic acid 30 mg/kg BW/day which divided into 3 doses for 7 days. Liver

function test were done after 7 days treatment. Primary outcome are an improvement of liver

function parameter and the secondary outcome are mortality rate and length of hospital stay.

Statistical analysis with t test/ Mann-Whitney test was done for primary outcome and length

of hospital stay, x2 test for differences of mortality, and Kaplan Meier method for survival

analysis.

Result. There were 37 subject, 19 subject in UDCA group and 18 in placebo group. There

were no significant differences of liver function parameter between UDCA group and

placebo [total bilirubin (2.2 ± 2.9 vs 1.7 ± 4.6; p= 0.080), direct bilirubin (1.1 ± 2.3 vs 0.6 ±

.6; p= 0.080), indirect bilirubin [0.4 (0.1-5.6) vs 0.9 (0.1-4.1); p= 0.358], ALT (0.5 [(-80.0) –

(21.0)] vs -2.0 [(-167.0) – (85.0)]; p= 0.730), AST (43.0 (14.0-297.0) vs 150.0 (24.0-840.0);

p= 0.081), and GGT (125.0 (48.0-481.0) vs 235,0 (56.0-456.0); p= 0.108)]. Although that,

there were a better improvement of total bilirubin, direct bilirubin, and AST in UDCA group.

Decrease of total bilirubin and direct bilirubin level occurred in 85.7% and 78.6% in UDCA

group vs 64.3% and 64.3% in placebo group. For the AST level, there was an improvement

in 57% subject UDCA with the profound declining 72 U/L; conversely, deterioration

occurred in 57% subject placebo, with the maximal increment 473 U/L. Mortality occurred

in 10.5% subject in UDCA group and 27.7% placebo group (p=0.232). There were no

differences of survival from both groups. Length of hospital stay in UDCA and placebo

group were 15-70 days and 10-88 days (p=0.148).

Conclusion: UDCA treatment 30 mg/kgBW/day for 7 days tends to decrease the total

bilirubin, direct bilirubin, AST level, and mortality, although not statistically significant.

This could be happened due to the limitation of power in this study. Future studies with

larger subject and longer duration of UDCA treatment will be needed."

2013

T-Pdf

UI - Tesis Membership Universitas Indonesia Library

Novitria Dwinanda

Profil ASI Eksklusif selama enam bulan serta faktor-faktor yang memengaruhinya pada bayi cukup bulan sesuai masa kehamilan dengan persalinan normal di Rumah Sakit Cipto Mangunkusumo = Profile and the factors affecting six months Exclusive Breastfeeding in term babies with normal births at Cipto Mangunkusumo Hospital / Novitria Dwinanda

"ABSTRAK

Latar belakang: Pemberian ASI eksklusif oleh ibu sehat pada bayi sehat cukup bulan sesuai masa kehamilan dengan persalinan normal seharusnya tidak memiliki kendala, namun cakupan pemberian ASI eksklusif di Indonesia semakin menurun.

Tujuan: Mengetahui insidens keberhasilan pemberian ASI eksklusif di RSCM dan faktor yang memengaruhinya setiap bulan selama 6 bulan.

Metodologi: Studi kohort prospektif analitik pada 243 ibu sehat yang memiliki bayi sehat cukup bulan sesuai masa kehamilan, dengan persalinan normal di RSCM. Wawancara terarah dilakukan setiap bulan selama enam bulan. Analisis bivariat dan multivariat regresi logistik dilakukan pada faktor yang memiliki jumlah subyek seimbang.

Hasil: Insidens ASI eksklusif, yaitu sebesar 64,8% (bulan-1); 53,7% (bulan-2); 43% (bulan-3); 30,7% (bulan-4); 23,5% (bulan-5); dan 22,3% (bulan-6). Keberhasilan ASI eksklusif dipengaruhi oleh inisiasi menyusu dini hingga bulan-2, ibu tidak berkerja/bersekolah pada bulan-3 hingga bulan-6, keyakinan ibu akan produksi ASI hingga bulan-6, dukungan suami/keluarga hingga bulan-6, perasaan tidak stres pada bulan-2 dan bulan-3 (p<0,028). Analisis multivariat menyimpulkan keyakinan ibu akan produksi ASI memengaruhi keberhasilan ASI eksklusif setiap bulan dengan resiko relatif (RR) dan 95% interval kepercayaan (IK) sebesar 14,85 dan 6,9-31,94 (bulan-1); 44,26 dan 10,16-192,75 (bulan-2); 14,62 dan 4,88-43,83 (bulan-3); 32,28 dan 4,23-246,37 (bulan-4); 19,85 dan 2,57-153,16 (bulan-5); 19,02 dan 2,47-146,31 (bulan-6). Dukungan suami/keluarga memengaruhi keberhasilan ASI eksklusif setiap bulan dengan RR dan 95%IK sebesar 4,06 dan 2,06-8,03 (bulan-1); 4,93 dan 2,5-9,73 (bulan-2); 2,35 dan 1,15-4,81 (bulan-3); 5,44 dan 2,03-14,59 (bulan-4); 6,49 dan 1,77-23,75 (bulan-5); 24,43 dan 3,20-186,42 (bulan-6). Ibu bekerja/sekolah memengaruhi keberhasilan ASI eksklusif pada bulan ketiga (RR 3,38; 95%IK 1,21-9,43) and bulan keempat (RR 6,56; 95%IK 1,39-30,99).

Simpulan: Insidens ASI eksklusif di RSCM menurun setiap bulannya hingga 6 bulan. Faktor yang memengaruhi keberhasilan ASI eksklusif setiap bulan selama enam bulan bersifat multifaktorial.

ABSTRACT

Background: Exclusive breastfeeding by healthy mothers to healthy term babies with normal birth is not supposed to be a problem yet the coverage of exclusive breastfeeding in Indonesia is declining.

Objective: To obtain the success rate incidence for exclusive breastfeeding and its affecting factors in every month for six months

Methods: A prospective analytical cohort study in 243 healthy mothers with healthy term babies with normal birth at CMH. Guided interviews were conducted every month for six months. Bivariate and multivariate were performed on factors with equal subject numbers.

Results: Exclusive breastfeeding incidences are 64.8% (first month); 53.7% (second month); 43% (third month); 30.7% (fourth month); 23.5% (fifth month); and 22.3% (sixth month). The multivariate analysis concluded that the mother’s belief of breastmilk production affects the exclusive breastfeeding success for every month with RR dan 95%CI: 14.85 and 6.9-31.94 (first month); 44.26 and 10.16-192.75 (second month); 14,62 and 4.88-43.83 (third month); 32,28 and 4.3-246.37 (fourth month); 19.85 and 2.57-153.16 (fifth month); 19.02 and 2.47-146.31 (sixth month). The husband/family support affects the exclusive breastfeeding success with RR and 95%CI: 4.06 and 2.06-8.03 (first month); 4.93 and 2.5-9.73 (second month); 2.35 and 1.15-4.81 (third month); 5.44 and 2.03-14.59 (fourt month); 6.49 and 1.77-23.75 (fifth month); 24.43 and 3.20-186.42 (sixth month). Non-working/studying mothers affects the exclusive breastfeeding success for the third month (RR 3.38; 95%CI 1.21-9.43) and fourt month (RR 6.56; 95%CI 1.39-30.99).

Conclusions: Exclusive breastfeeding incidence in CMH declined every month up to sixth month. Factors affecting the success for each month in the six months are multifactorial."

[Fakultas Kedokteran Universitas Indonesia, ], 2012

T-Pdf

UI - Tesis Membership Universitas Indonesia Library

Dina Indah Mulyani

Faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum = Risk factors of intractable childhood generalized epilepsy

"[ABSTRAK

Latar belakang: Epilepsi umum merupakan jenis epilepsi yang sering dijumpai pada anak. Data mengenai faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum masih sangat terbatas. Perlu dilakukan penelitian lebih lanjut untuk mengetahui faktor risiko yang berperan dalam kejadian epilepsi intraktabel sehingga dapat menjadi dasar dalam tata laksana serta edukasi pasien dan orangtua.

Tujuan: (1) Mengetahui karakteristik pasien epilepsi umum dan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi umum . (2) Mengetahui apakah usia awitan, tipe kejang, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran MRI/CT Scan kepala dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umum. (3) Mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umum

Metode: Penelitian kohort retrospektif berdasarkan rekam medis dilakukan di poliklinik rawat jalan neurologi anak Departemen Ilmu Kesehatan Anak FKUI-RSCM dan poliklinik anak swasta RSCM antara bulan September sampai dengan Desember 2014 terhadap anak epilepsi umum usia koreksi 1 bulan hingga 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat.

Hasil: Angka kejadian epilepsi umum intraktabel adalah 21 (21%). Usia subjek terbanyak adalah usia >3 tahun sebanyak 85(83%) subjek. Pada analisis bivariat didapatkan faktor risiko yang bermakna adalah usia awitan kejang <1 tahun (OR 11,4 IK 95% 3,45-37,62), frekuensi awal serangan ≥5 kali/hari (OR 8,5 IK95% 2,90-24,80), respon awal terapi buruk (OR 160 IK 95% 19,12-1339,06), evolusi status perkembangan motor kasar buruk (OR 4,9 IK95% 1,79-13,67) dan evolusi EEG epileptiform buruk (OR 10 IK95%3,25-30,92). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR 144,3 (IK95% 15,47-1345,59) dan usia awitan kejang < 1 tahun dengan nilai OR 9,6 (IK95% 1,78-51,92) merupakan faktor risiko yang berpern untuk menjadi epilepsi umum intraktabel.

Simpulan : Angka kejadian epilepsi umum intraktabel sebanyak 21%. Faktor risiko yang sangat berperan adalah respon terapi awal buruk dan usia awitan kejang <1 tahun.

ABSTRACT

Background: Generalized epilepsy is the most common type of epilepsy in children. Limited datas of intractable epilepsy risk factors are available at present. Therefore, more studies are needed to investigate the risk factors of intractable epilepsy in order to manage and educate both patients and parents.

Objective: (1) to describe characteristic and frequency of intractable epilepsy in children with generalized epilepsy, (2) to investigate the role of age onset of seizure, initial seizure frequency, type of seizure, early gross motor developmental status, early therapeutic response, early EEG description and cerebral MRI/CT scan as risk factors of intractable epilepsy in children with generalized epilepsy, (3) to investigate the role of gross motor developmental status evolution and epileptiform EEG evolution as risk factors of intractable epilepsy.

Methods: Retrospective cohort study was conducted at neurology outpatient pediatric RSCM and private outpatient clinic between September to December 2014. The inclusion criteria was generalized epilepsy children age 1 month of corrected age to 18 years old which has been treated with antiepileptic drugs for at least 6 months. Risk factors were analyze with bivariate and multivariate analysis.

Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are >3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure (OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI 95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,12-1339,06), unfavorable gross motor development evolution (OR 4,9 CI 95% 1,79-13,67) and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are significantly associated with intractable epilepsy. The most important among those risk factors based on multivariate analysis are non-responder of early treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with OR 9,6 (CI 1,78-51,92).

Conclusions: Prevalence of intractable generalized epilepsy is 21%. Non-responder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy in

children. Limited datas of intractable epilepsy risk factors are available at present.

Therefore, more studies are needed to investigate the risk factors of intractable

epilepsy in order to manage and educate both patients and parents.

Objective: (1) to describe characteristic and frequency of intractable epilepsy in

children with generalized epilepsy, (2) to investigate the role of age onset of

seizure, initial seizure frequency, type of seizure, early gross motor developmental

status, early therapeutic response, early EEG description and cerebral MRI/CT

scan as risk factors of intractable epilepsy in children with generalized epilepsy,

(3) to investigate the role of gross motor developmental status evolution and

epileptiform EEG evolution as risk factors of intractable epilepsy.

Methods: Retrospective cohort study was conducted at neurology outpatient

pediatric RSCM and private outpatient clinic between September to December

2014. The inclusion criteria was generalized epilepsy children age 1 month of

corrected age to 18 years old which has been treated with antiepileptic drugs for at

least 6 months. Risk factors were analyze with bivariate and multivariate analysis.

Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are

>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure

(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI

95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),

unfavorable

gross

motor

development

evolution

(OR

4,9

95%

1,7913,67)

and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are

significantly associated with intractable epilepsy. The most important among

those risk factors based on multivariate analysis are non-responder of early

treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with

OR 9,6 (CI 1,78-51,92).

Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy in