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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Plastik Rekonstruksi Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Cermin Dunia Kedokteran
I Wayan Niryana
Bagian SMF Ilmu Bedah RSUP Sanglah Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Journal : BALI MEDICAL JOURNAL (BMJ)

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Initial Clinical Findings as a Predictor of Abnormal Scan on Minor Head Injury Patients at Sanglah General Hospital, Bali-Indonesia -, Ade-Chandra; Niryana, W; Golden, N
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

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Objective: Minor Head Injury (MHI) patients should not cause severe sequelae. In fact, many studies had reported that some MHI patients had abnormal scan, clinical deteoritation, and many of them have had neurosurgical intervention. This study analyzed correlations between clinical signs with abnormal scan, clinical deteoritation and surgery intervention on minor head injury patients. Methods: A series of 364 MHI patients were prospectively enrolled in this study. In all cases clinical data were collected and a CT Scan was obtained. The relationship between clinical findings (loss of conciousness, amnesia, seizure, vomiting, headache, cepalhameatome, skull fracture, age more than 60 years),were identified as independent risk factors in corelations to abnormal scan, clinical deteoritation and surgery intervention using bivariate and logistic regresion multivariate analitycs with 95 % CI. Results: the incidence of abnormal scan was 13.8% (48 patients), 3.3% (12 patients) with clinical deteoritation, and incidence of surgery intervention was 3.8% (14 patiens).  Lost of conciousness, amnesia, cepalhematoma, skull fracture, and age more than 60 years old  are independent variabels had statisiticly significant with abnormal scan. Amnesia, cepalhematome, skull fracture are independent variables which had statisitc significantly with  clinical deterioritation and surgical intervention. Conclusions: Clinical variables which had statistic significanly can be used as predictors of abnormal scan, clinical deteoritation, and surgical intervension. Avoiding systematic CT Scan indication implies a rate of misdiagnosis, but liberal scan can be increasing the cost of patients.
Risk Factors for Neuroworsening of Moderate Head Injury Cases in Emergency Department Sanglah General Hospital Bali-Indonesia Sasongko, J; Niryana, W; Golden, N
BALI MEDICAL JOURNAL Volume 1, Number 1, January-April 2012
Publisher : BALI MEDICAL JOURNAL

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Objectives: To determine risk factors such as hypoxia, hypotension, age >40 years old, amount of focal lesion, low GCS upon arrival, and female associated with neuroworsening of moderate head injury cases. Method: The study was a cohort study on 152 cases of moderate head injury admitted in Surgery Department/Udayana University Faculty of Medicine/Sanglah General Hospital from April 2010 – March 2011. The variables were analyzed using multiple logistic regression model (p<0.05). Results:  The multivariate analysis showed age group ?40 years old {OR 4,490 (CI 95%: 1,750 – 11,521) p=0,002}, male sex {OR 2,276 (CI 95%: 0,810 – 6,395) p=0,119}, initial GCS 9-12 {OR 2,905 (CI 95%: 0,097 – 24,440) p=0,048}, hypoxia {OR 13,582 (IK 95%: 4,315 – 42,750) p=0,000},  hypotension {OR 5,179 (CI 95%: 1,097 – 24,440) p=0,038}, and multiple focal lesion {OR 5,674 (CI 95%: 2,008 – 16,038) p=0,001} were risk factors for neuroworsening in moderate head injury cases. Area Under Curve value was 84.7% from the Receiver Operator Curve. Conclusions: This study showed that hypoxia, multiple focal lesion, age ?40 years old, and hypotension were risk factors for neuroworsening in moderate injury cases.
Co-Authors A.A Davyn Anantha Ade-Chandra - Agung Aditya Arnaya Agung Bagus S. Satyarsa Agus Roy Hamid Agus Roy Rusly Hariantana Hamid Anne Saputra D.P.W. Wardhana Dewa Ayu Wahyu Diantari Dewa Ngurah Suprapta Dewa Putu Wisnu Wardhana Dwijo Anargha Sindhughosa Ellintang Charisma Dewi Gitari, Ni Made Gusti Ngurah Agung Adi Paramartha Hendra Sanjaya I Gde Made Satya Wangsa Satya Wangsa I Gede Sutawan I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Lanang Ngurah Agung Artha Wiguna I Gusti Ngurah Purnomo I Gusti Putu Hendra Sanjaya I Made Bagus Wirawan I Made Jawi I Made Suka Adnyana I Made Sukarya I Nyoman Semadi I Putu Eka Widyadharma I Putu Gede Cahya Giartha Putra I Putu Yuda Prabawa Ida Bagus Yudha Prasista J Sasongko K.K. Putra Kevin Kristian Putra Koerniawan, Heru Sutanto Loelita Marcelia Lumintang Made Agus Dwianthara Sueta Made Favian Budi Gunawan Made Indra Erlangga Prathiwindya Made Suka Adnyana Marthinson Andrew Tombeng Melissa Krisanty Moses Kharisma Setyawan Mumtazah Mardliyah Ni Luh Putu Julita Yanti Ni Putu Ayu Pande Arista Dewi Ni Putu Sri Wulandari Nyoman Golden Nyoman Siska Ananda Putu Anda Tusta Adiputra Putu Ayu Indra Shanti Wardani Putu Chandra Wibawa Putu Diahpradnya Oka Partini Putu Eka Mardhika Raka-Sudewi A. A. S. Awyono Sanjaya, Feliani Sianny Herawati Sri Maliawan Tham Hong Yuan Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa