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All Journal Jurnal Anestesi Perioperatif Majalah Kedokteran Nusantara The Journal Of Medical School
Achsanuddin Hanafie
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Education Health Professions Medicine & Pharmacology

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Hubungan Nilai Mean Platelet Volume (MPV) dengan Skor APACHE II sebagai Prediktor Mortalitas pada Pasien Sepsis Berat di Rumah Sakit Umum Pusat Haji Adam Malik Medan M. Teguh Prihardi; Achsanuddin Hanafie; Soejat Harto
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Sepsis berat merupakan kondisi umum di unit perawatan intensif (UPI) dan rawat inap yang berhubungan dengan mortalitas, morbiditas, dan biaya perawatan yang tinggi. Tujuan penelitian ini ingin mendapatkan skor alternatif yang lebih sederhana, yaitu nilai mean platelet volume (MPV) sebagai prediktor mortalitas pada pasien sepsis berat selain skor APACHE II. Penelitian ini menggunakan desain cross sectional pada 76 pasien sepsis berat dewasa di Rumah Sakit H. Adam Malik Medan pada Oktober 2015–Januari 2016 yang memenuhi kriteria inklusi. Data yang diambil adalah nilai MPV dan skor APACHE II pada saat pertama sekali terdiagnosis sepsis berat, kemudian dilihat mortalitas pasien tersebut. Uji korelasi Spearman menunjukkan bahwa terdapat korelasi lemah yang signifikan (p=0,006) antara MPV dan APACHE II dengan nilai r (korelasi) = 0,314. Nilai MPV pada penelitian ini tidak memiliki kemampuan dalam memprediksi mortalitas (AUC) ROC 58,2% (IK 95%: 45,1–71,2%; p=0,223); sedangkan skor APACHE II memiliki kemampuan yang sedang dalam memprediksi mortalitas (AUC) ROC 70,4% (IK 95%: 58,6–82,2%; p= 0,002). Didapatkan cut-off point untuk APACHE II adalah 19 dengan sensitivitas 65,9%, spesitivitas 65,7%, NPP 69,2%, dan NPN 62,2%. Simpulan penelitian ini adalah nilai MPV tidak dapat dijadikan prediktor mortalitas pada pasien sepsis beratKata kunci: Mean platelet volume, mortalitas UPI, skor APACHE II Correlation between Mean Platelet Volume (MPV) and Apache II Score as Mortality Predictors in Severe Sepsis Patients at Haji Adam Malik General Hospital MedanAbstractSevere sepsis is a general condition in the Intensive Care Unit (ICU) and inpatient wards which correlates with mortality, morbidity, and high cost hospitalization. The main point of this study was to explore the possibility to use the mean platelet volume (MPV) as an easier alternative score for mortality predictor in addition to APACHE II score in severe sepsis patients. This study used cross-sectional design on 76 adult severe sepsis patients in Haji Adam Malik General Hospital Medan who met inclusion criteria during the periood of October 2015 to January 2016. Data collected were MPV value and APACHE II score, which were collected the first time patient was diagnosed as having severe sepsis which was then observed for their mortality The Spearman correlation tests showed that there was a weak yet significant correlation (p=0.006) between MPV and APACHE II with r (correlation) = 0.314. The MPV values in this study were unable to predict mortality (AUC) ROC 58.2% (95% CI: 45.1–71.2%, p=0.223). whereas the APACHE II score has a moderate ability to predict mortality (AUC) ROC 70,4% (95% CI: 58,6–82,2%, p= 0.002). The cut-off point of APACHE II was 19 with a sensitivity of 65.9% and a specificity of 65.7%, and a PPV of 69.2% and NPV of 62.2%. Therefore, based on this study the MPV score cannot be used as a mortality predictor in severe sepsis patients.Key words: APACHE II score, mean platelet volume, ICU mortality DOI: 10.15851/jap.v4n3.901
Perubahan kadar albumin dan prealbumin etelah suplementasi ekstrak ikan gabus metode freeze dryer pada pasien sepsis Ahmad Fiza Putera; Achsanuddin Hanafie; Dadik Wahyu Wijaya
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 2 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction : Septic is the second highest cause of death in Intensive Care Unit and 10 highest cause of death in the world overall. Mortality and Morbidity of sepsis in relation with hypoalbuminemia, with the number incidence 60-70%. The principal of nutritional management in septic patient is how to manage calories and high protein to balance the catabolic process. Extract of snakehead fish is the source of high protein in compare with other sources. The purpose of this study is to know the level of albumin and prealbumin after the sumplementation of extract of snakehead fish with the freezy dryer methode. Methodes : The Randomized Control Trial double blinded which done in Mei-June 2016 in Rumah Sakit Umum Pusat Haji Adam Malik Medan. The total of 38 Patients whose included in inclusive and exclusive criteria for this research. Level of albumin and preabulmin was measuring after the suplementation extract of snakehead fish with the methode of freezy dryer as suplementation of protein as a enteral nutrition in 3 days intervention. In a group with suplementation extract of snake head fish with the methode of freezy dryer increased the level of albumin 0.26 gr/dL (p<0.001) and the level of prealbumin 9.36 mg/dL (p<0.001). In difference with the group given placebo, the level of albumin decreased 0.32 gr/dL (p<0.001) and the decreased of prealbumin 4.58 mg/dL (p<0.001).Result : Extract of snakehead fish with the freezy dryer extraction could increase 0.26 mg/dL albumin level and 11.26 mg/dL prealbumin level.Conclussion : suplementation of snakehead fish with the freezy dryer methode could increase albumin and prealbumin level efectively.Keyword : additional protein intake, hypoalbuminemia, nutrition, sepsis
Co-Authors Ahmad Fiza Putera Dadik Wahyu Wijaya M. Teguh Prihardi Soejat Harto