Garuda - Garba Rujukan Digital

Sensitivity and specificity of serum procalcitonin level compared to leucocyte count for diagnosis surgical site infection on patients undergoing major surgery in Dr. Sardjito General Hospital Yogyakarta Muhammad Sayuti; . Supomo; Umi Sholekah Intansari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Surgical site infection (SSI) is one of the most serious complications on sugical procedure. However, its diagnosis is still based on the clinical and laboratory examination that take more time and less sensitive and specific. Therefore, early diagnosis that is more accurate and precise is needed. Some biomarker such as serum procalcitonin (PCT) is promoted for diagnosis SSI. The aim of the study was to evaluate the sensitivity and specificity of serum PCT compared with leucocyte for diagnosis SSI on patients undergoing major surgery. This was a descriptive analytical study with a prospective observational design. Patients who underwent a major surgery between October 30th and December 31rt, 2011 and fulfilled the inclusion and exclusion criteria were recruited. Clinical and laboratory examinations including leucocyte count were conducted presurgery. On 3rd day postsurgery, blood sample was taken for PCT and leucocyte count measurement. A blood bacterial culture was performed on patients suffering from SSI according to Centers for Disease Control (CDC) criteria. Patients were then followed until 30 days postsurgery. A total of 49 patients consisting of 22 men and 27 women were involved in this study. Surgical site infection was found in 16 patients consisting of 8 (50%) patients with clean surgical wound, 3 (19%) patients with clean surgical contamination wound, 4 (25%) patients with surgical contamination wound and 1 (6%) patient with dirty surgical wound. Furthermore, laboratory examination found that 9 patients had abnormal leucocyte with 5 of them suffering from SSI, whereas from 14 patients with serum PCT abnormal, 11 patients suffered from SSI. Diagnostic test showed that the sensitivity and specificity of serum PCT for diagnosis SSI were 68.75 and 90.90%, respectively, whereas the sensitivity and specificity of leucocyte were 31.25 and 87.87%, respectively. In conclusion, serum PCT has better sensitivity and specificity compared with leucocyte for the diagnosisof SSI in patients with major surgery.

Sensitivity of serum C-reactive protein (CRP) levels compared to white blood cell count (WBC) as a predictor of surgical site infection in patients undergoing major surgery Felix Hangandi; . Supomo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 04 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Early diagnosis and treatment of infections is essential in the care of the surgical patients. Rapidand appropriate diagnosis for an infection can prevent irrational use of antibiotics in the surgicalcare. A blood culture is a standard method to detect and identify bacteria causing the infections.However, it is time-consuming to confirm the results. Therefore, an alternative method thatsensitive and specific to reduce the time necessary to confirm the laboratory report is urgentlyneeded. The aim of this study was to compare the sensitivity and specificity of C-reactiveprotein (CRP) with white blood cell (WBC) count as a predictor of surgical site infection (SSI) inpatients who underwent major surgery. This was a descriptive analytical study with a prospectiveobservational design involving patients who underwent major surgery in Department of Surgery,Dr. Sardjito General Hospital, Yogyakarta between Octobers until December 2011. On the thirdday post operative surgery, serum CRP level and WBC were measured. In addition, bacterialculture from the surgical wound of patients who suffered SSI, according to Centers for DiseaseControl (CDC) criteria, was performed. Among 49 patients who involved in this study, 16patients (32.7%) suffered from SSI consisting 12 cases of superficial SSIs and 4 cases of deepSSIs. Among 9 patients who had an abnormal WBC count, 6 patients experienced SSI, whileamong 9 patients who had CRP serum levels above 8 mg/dL, 7 patients suffered from SSI. Thesensitivity and specificity of serum CRP levels in predicting SSI was 43.75% and 93.93%,respectively. Whereas the sensitivity and specificity of WBC was 31.25% and 87.87%,respectively. In conclusion, CRP is more sensitive and specific than WBC in predicting SSI inpatients who underwent major surgery.

Prognostic factors for heart valve surgery outcomes in Dr Sardjito General Hospital Yogyakarta, Indonesia Wahyu Priyatno; . Supomo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 2 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Heart valve disease is a serious health probem due its significant effect on mortality.Surgical intervention plays an importan roleinthe management of moderate to the severe valvular heart disease. The evaluation of the patientoutcomes has been widely accepted as one of the important steps to improve the quality of patient care.Recognition of post operative complications might significantly affect the patient quality of life.Therefore, the identification of prognostic factors and morbidity of heart surgery patients can provide valuable insights on improving the quality of patient care.This study aimedto investigat the prognostic factors for heart valve surgery outcomes in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. This study was conducted using data ofpatient’s medical records who underwent heart valve surgeryincluded morbidities and their prognostic factors.The data were analyzed using Chi-square test and logistic regression with significance level of 0.05. During 2010 to 2014, 82 patients underwent heart valve surgeries at the hospital. The kidney disorders and heart failure were significantly associated with the patient morbidity (p<0.05),while the gender, pulmonary disease, angina, and impaired ventricular function were not (p>0.05). Multivariate analysis showed that the heart failure is the most significant factor of morbidity. The risk of New York Heart Association (NYHA) class 3 patients were 7.18 times compared with NYHA class 2 patients. In conclusion, the heart failure is the most significant factor for the morbidityof heart valve surgery followed by the kidney disorders at the Dr. Sardjito General Hospital.

The effect of combination of hemofilter, pre- and intraoperative methylprednisolone administration on systemic inflammatory response syndrome (SIRS) post open heart surgery . Supomo; Teguh Aryandono; Marsetyawan Soesatyo; Paulus Sudiharto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Systemic inflammatory response syndrome (SIRS) occurs in almost all patients whom undergo open heart surgery causes the increase its morbidity and mortality. The effect of pre- and intraoperative methylprednisolone administration combined with hemofilter application in cardiopulmonary bypass machine in the reduction of SIRS incidence remains controversial. This study aimed to evaluate the effect pre- and intraoperative methylprednisolone administration combined with hemofilter on SIRS incidence after open heart surgery. This was an experimental study using prospective randomized open-blinded evaluation (PROBE) design. Ninety-five patients from Dr. Sardjito General Hospital, Yogyakarta, and Dr. Cipto Mangunkusumo General Hospital, Jakarta, who had open heart surgery within the period of December 2011 to May 2012 were enrolled in this study. The patients were randomly allocated into two groups i.e. Group A (48 patients) received pre-; intra-; and postoperative methylprednisolone (15; 5 and 5 mg/kg BW, respectively) and hemofilter and Group B (47 patients) just received intra- and postoperative methylprednisolone (15 and 5 mg/kg BW). The SIRS incidence was evaluated in 3; 24; 48 and 72 hours post surgery. This study showed that the SIRS incidence in Group B at 3 (OR= 0.12; 95%CI=0.03-0.39; p< 0.001) and 24 (OR= 0.38; 95%CI=0.14-0.996; p< 0.031) hours postoperative were significantly higher than that in Group A. In conclusion, pre- and intraoperative methylprednisolone administration combined hemofilter significantly decrease the SIRS incidence post open heart surgery.

The effect of hemofilter, preoperative and intraoperative methylprednisolone on complications after open heart surgery . Supomo; Teguh Aryandono; Marsetyawan Soesatyo; Paulus Sudiharto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 4 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Complications after open heart surgery may threaten patient’s survival rate. Theintraoperative methylprednisolone administration alone shows controversial resultson open heart surgery complications. Similarly, the intraoperative and preoperativemethylprednisolone administration as well as the use of hemofilter in open heart surgeryis still controversial. This study aimed to evaluate the effect of hemofilter, preoperativeand intraoperative methylprednisolone administration on complications following openheart surgery. This was a Prospective Randomized Open-Blinded Evaluation (PROBE)experimental study. Ninety-five patients who had open heart surgery in Dr. SardjitoGeneral Hospital, Yogyakarta, and Integrated Cardiac Care of Dr. Cipto MangunkusumoGeneral Hospital, Jakarta within the period of December 2011 to May 2012 wereinvolved in this study. The patients were divided into two groups i.e. group A, 48 patientsreceived methylprednisolone 15mg/kg intraoperatively, methylprednisolone 5mg/kgpreoperatively, and hemofilter, while group B, 47 patients received methylprednisolone15mg/kg intraoperatively alone. From the total 95 patients, we found 26 (27.4%)patients experienced complications i.e. 19 in group B (40.4%) and 7 in group A(14.6%). The differences of the complications were statistically significant (p<0.05;OR=3.97; 95%CI=1.476-10.71). Complications risk decreased by 63.9% in the groupA compared to the group B with the hazard ratio of 3.2. In conclusion, the application ofhemofilter, preoperative and intraoperative methylprednisolone might decrease the risk ofcomplications after open heart surgery.

Infective endocarditis as a morbidity predictor in patients who underwent mitral valve surgery Supomo Supomo; Kelik Wagiyanto; Aditya Agam Nugraha
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 3 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Infective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surgery

Prognostic factor for prolonged ventilator usage and ICU occupancy time after mitral valve replacement surgery: a retrospective cohort study . Supomo; Herpringga Lara Sakti; Galih Asa Andrianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

This study was conducted to identify the prognostic factors for prolongedventilator usage time and ICU occupancy time after mitral valve replacement(MVR) surgery. It was a retrospective cohort study involving 70 MVR surgerypatients at Dr. Sardjito General Hospital, Yogyakarta, Indonesia during theperiod of January 2013 to December 2018. Prognostic factors as independentvariables including age, gender, heart failure, ejection fraction, pulmonaryhypertension, chronic pulmonary disease, active endocarditis, renalinsufficiency, duration of aortic cross clamp (AOX) time and cardiopulmonarybypass (CPB) time were evaluated. Where as the dependent variables werethe prolongation of ventilator usage time (>24 h) and the intensive care unit(ICU) occupancy time (>96 h). Of the total 70 studied patients, 25 patients(35.7%) used ventilator >24 h, meanwhile 15 patients (21.4%) occupied the ICU>96 h. Patients who used ventilator >24 h had CPB time ≥126.5 min (OR=10;95%CI=2.581-41.252), renal insufficiency (OR= 14; 95%CI = 1.487-150.970), andactive endocarditis (OR=7; 95%CI = 1.257-45.213). Meanwhile, patients whooccupied the ICU >96 h had age ≥40 years old (OR=6.4; 95% CI = 1.26-15.3),CPB time ≥126.5 min (OR=5.7; 95% CI = 1.8-38.1), and heart failure with NYHAfunctional classification 3 (OR=9.8; (95% CI = 1.4-67.2). In conclusion, theprognostic factors for prolonged ventilator usage time after MVR surgery areCPB time ≥126.5 min, renal insufficiency and active endocarditis. Furthermore,the prognostic factors for prolonged ICU occupancy time are age ≥40 years old,heart failure with NYHA functional classification 3 and CPB time ≥126.5 min.

Prognostic factors influencing prolonged ventilation after open mitral valve surgery Supomo Supomo
Majalah Kedokteran Andalas Vol 43, No 1 (2020): Published in January 2020
Publisher : Faculty of Medicine, Universitas Andalas

Objective: To determine prognostic factors influencing prolonged ventilation after surgery in our hospital. Method: Seventy-five patients fulfilled inclusion criteria were included in this retrospective cross-sectional study. Prognostic factors analyzed were age, chronic pulmonary disease, heart failure (NYHA class function), left ventricular (LV) dysfunction (based on ejection fraction), recent myocardial infarction, pulmonary hypertension (PH), duration of cardiopulmonary bypass (CPB), ischemic time and aorta clamp time, which were analyzed in relation to prolonged ventilation after open mitral valve surgery. Results: Subjects were 75 patients aged between 19 and 62 years old (mean 39.76, SD 11.44) whom underwent open mitral valve repair or replacement surgery. Twenty-three patients (30.67%) had prolonged ventilation (≥24 hours) after surgery. Bivariate analysis showed there were no significant correlation between age, heart failure, PH and LV dysfunction. There are different with statistically significance between groups (p<0.05). Conclusions: In this study, almost one-third of patients had prolonged ventilation after surgery. Factors influencing this morbidity were the duration of ischemic time, aorta clamp time and CPB. Age, heart failure, LV dysfunction and PH were not statistically related to the prolonged ventilation event.

Successful late repair of popliteal artery rupture with compartment syndrome Supomo Supomo
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 8, No 3, (2017)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol8.Iss3.art5

Fatal Complications and high amputation rate were reported in popliteal artery rupture cases. Diagnosis delay and revascularization failure within 6 hour of Golden Period are related to amputation and death, even when specialist intervention is available. We report a patient with popliteal artery rupture and compartment syndrome, which was successfully underwent artery repair surgery after 42 hours of delayed revascularization. This case illustrates that delayed revascularization might produce an acceptable outcome in a particular circumstance.

Outcome Comparison Between Insulin-Dependent and Non Insulin-Dependent Patients after Open Adult Cardiac Surgery Juni Kurniawaty; Budi Yuli Setianto; Supomo Supomo; Yunita Widyastuti; Cornelia Ancilla; Cindy Elfira Boom
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 3, No 1 (2023): April 2023
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v3i1.66306

Background: Insulin-dependent diabetic patients usually have poor glycemic control and higher risk of complications than non-insulin-dependent diabetic patients. However, the difference in clinical outcomes between these two groups of patients who underwent open cardiac surgery was not established. Therefore, this study compares the short-term outcome of insulin vs non-insulin-dependent diabetic patients after open cardiac surgery in a large-scale study.Methods: The study design was a retrospective cohort. All adults who underwent open cardiac surgery between January 1st 2016-December 31st 2020 in 4 tertiary hospitals in Indonesia were included in the study. From a total of 4.931 samples included in the study, 3.753 patients were non-diabetic (Group I) and 1.178 were diabetic (Group II). Group II was divided into subgroup IIA (930 non-insulin-dependent) and subgroup IIB (248 insulin-dependent). The main outcome was in-hospital mortality of open cardiac surgery patients.Result: In-hospital mortality between group I and II had no significant difference (6.8% vs 5.7%; p = 0.188), as well as IIA and IIB (5.6% vs 6%; p = 0.782). Multivariate analysis demonstrated that diabetes did not increase mortality of open cardiac surgery (OR 0.665; p = 0.021). In-hospital mortality of subgroup IIB was higher than subgroup IIA, but insulin therapy did not increase the risk of in-hospital mortality (OR 1.259; p = 0.464).Conclusion: Both insulin-dependent and non-insulin-dependent diabetes mellitus were not the predictors of poor short-term outcomes for open adult cardiac surgery patients.

Title

Found 10 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 10 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 10 Documents
Search