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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina journal of internal medicine Sport and Fitness Journal Buletin Udayana Mengabdi INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Health Science Journal of Indonesia Jurnal Farmasi Klinik Indonesia WMJ (Warmadewa Medical Journal) The Indonesian Biomedical Journal Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran JURNAL HUKUM PRASADA JURNAL ILKES (Jurnal Ilmu Kesehatan) Indonesian Journal of Global Health research Public Health and Preventive Medicine Archive Jurnal Penyakit Dalam Indonesia
R. A.T. Kuswardhani
Divisi Geriatri, Departemen Ilmu Penyakit Dalam, Universitas Udayana, Denpasar
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Journal : ISM (Intisari Sains Medis) : Jurnal Kedokteran

 1 
Hubungan antara kejadian delirium dengan anemia pada pasien geriatri di bangsal rawat inap geriatri RSUP sanglah Shelvy Florence Gousario; RA Tuty Kuswardhani
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (261.967 KB) | DOI: 10.15562/ism.v11i2.625

Abstract

Background: Delirium is common, occurs in 20% to 79% of hospitalized older patients. It has been associated with increased health care costs, long-term cognition deficits, and increase mortality. Anemia has been noted as one of predisposing factors for delirium. Elderly patients with many risk factors will be vulnerable to a low level precipitating insult, whereas those without risk factors may only become delirious after a high level insult. The objective of this study was to find association between delirium status and anemia among elderly patients.Method: cross-sectional design using analytic observational was conducted with purposive sampling. Total subject of this study was one hundred and sixteen elderly patients, taken at geriatric ward Sanglah general hospital from January to May 2016. Delirium status was screened using Confusion Assessment Method (CAM). Assessment of delirium was confirmed if meet the criteria acute, fluctuating onset an inattention, plus disorganized thinking and/or changes in consciousness. Anemia was defined as level of serum hemoglobin < 10 g/dL. Statistical analysis used was chi square comparative test .Results: One hundred and sixteen elderly patients age 60 to 95 years old with mean 72.16 + 8.179 were included. The prevalence of delirium and anemia were 28 (24.1%) and 40 (34.5%) respectively. We found significant association between delirium status and anemia (p= 0.034).Conclusion: there was significant association between delirium status and anemia among elderly patients at geriatric ward Sanglah general hospital. Pendahuluan: Delirium merupakan suatu keadaan yang sering terjadi pada 20 hingga 70% pasien geriatri yang menjalani rawat inap. Keadaan ini dihubungkan dengan peningkatan biaya kesehatan, defisit kognitif jangka panjang, serta peningkatan mortalitas. Anemia telah diketahui sebagai salah satu faktor predisposisi terjadinya delirium. Pasien geriatri dengan banyak faktor risiko akan lebih rentan terhadap jejas yang kadarnya rendah. Penelitian ini bertujuan untuk mengetahui hubungan antara delirium dan anemia pada pasien geriatri.Metode: penelitian ini merupakan penelitian observasional dengan rancangan potong lintang analitik menggunakan consecutive sampling. Subjek dalam penelitian ini berjumlah 116 pasien yang berasal dari bangsal rawat inap geriatri RSUP Sanglah Denpasar pada Januari hingga Mei 2016. Delirium dievaluasi menggunakan metode CAM (Confusion Assessment Method). Anemia didefenisikan sebagai kadar hemoglobin serum <10 g/dL. Analisa statistik menggunakan uji komparatif chi-square.Hasil: Dari 116 pasien yang menjadi sampel dalam penelitian ini, didapatkan rata-rata umur 72,16 + 8,179 dengan umur terendah 65 tahun dan tertinggi 95 tahun. Prevalensi delirium dan anemia sebesar 28 (24,1%) dan 40 (34,5%) berturut-turut. Didapatkan adanya hubungan yang bermakna antara kejadian delirium dengan anemia (p= 0,034)Kesimpulan: Ada hubungan yang bermakna antara kejadian delirium dengan anemia pada pasien-pasien geriatri di bangsal rawat inap geriatri RSUP Sanglah Denpasar.
Prevalensi sarkopenia dan frailty di desa Pedawe, Mangupura, Serai dan Songan I Gusti Agung Wilaja Putra; I Gusti Putu Suka Aryana; I Nyoman Astika; RA Tuty Kuswardhani; Ida Bagus Putrawan; Ketut Rai Purnami
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1160.459 KB) | DOI: 10.15562/ism.v11i2.667

Abstract

Background: Frailty is characterized by a decrease in multi-organ physiological functions. Sarcopenia and frailty have a significant impact on individuals and society so it is necessary to know the prevalence in the community. This study aimed to determine the prevalence of sarcopenia and frailty in rural areasMethod: The was a cross-sectional study in the elderly population in the villages of Pedawa, Mangupura, Serai and Songan. Measurement of muscle mass using bioelectrical impedance analysis (BIA) and categorized based on the recommendation of the Asian Working Group for Sarcopenia (AWGS). Frailty is established through a screening questionnaire based on the Cardiovascular Health Study. The study was chosen by simple random sampling and population register data.Results: The study involved 235 elderly people with 117 people in Pedawe village, 71 people in Mangupura village, 34 people in Serai village and 13 people in Songan village with a composition of 35.5% men and 64.5% women. In this study sarcopenia in women was 51% and men 49%, while frailty was experienced in 58.9% women and 41.02% men. The mean age is 67.7 years. The prevalence of total sarcopenia is 59% with the lowest percentage ranging from the villages of Mangupura (30%), Songan (53.8%), Pedawe (70.9%), and Serai (79.4%). The overall frailty prevalence in the four villages is 17% with the percentage starting from the lowest being Mangupura (1.4%), Serai (5.9%), Songan (22.2%) and Pedawe (29.1%).Conclusions: The prevalence of sarcopenia and frailty is most common among elderly women. The highest prevalence of sarcopenia was found in Serai village and frailty prevalence was highest in Pedawe village. Latar Belakang: Frailty ditandai dengan adanya penurunan fungsi fisiologis multi organ. Sarkopenia dan frailty memberikan dampak yang bermakna bagi individu dan bagi masyarakat sehingga perlu untuk mengetahui prevalensinya di masyarakat. Penelitian ini bertujuan untuk mengetahui prevalensi sarkopenia dan frailty di daerah pedesaanMetode: Penelitian menggunakan studi potong lintang pada populasi lansia di desa Pedawa, Mangupura, Serai dan Songan. Pengukuran massa otot menggunakan bioelectrical impedance analysis (BIA) dan dikategorikan berdasarkan rekomendasi Asian Working Group for Sarcopenia (AWGS). Frailty ditegakkan melalui kuesioner skrining berdasarkan Cardiovascular Health Study. Penelitian dipilih dengan cara simple random sampling dan data register penduduk.Hasil: Penelitian melibatkan 235 orang lanjut usia dengan jumlah 117 orang di desa Pedawe, 71 orang di desa Mangupura, 34 orang di desa Serai dan 13 orang di desa Songan dengan komposisi 35,5% laki-laki dan 64,5% perempuan. Pada penelitian ini sarkopenia pada perempuan adalah 51% dan laki-laki 49%, sedangkan frailty dialami 58,9% perempuan dan 41,02% laki-laki. Rerata usia adalah 67,7 tahun. Prevalensi sarkopenia total adalah 59% dengan persentase masing-masing mulai dari yang terendah adalah desa Mangupura (30%), Songan (53,8%), Pedawe (70,9%), dan Serai (79,4%).  Prevalensi frailty keseluruhan di empat desa adalah 17% dengan persentase masing-masing  mulai dari yang terendah adalah desa Mangupura (1,4%), Serai (5,9%), Songan (22,2%) dan Pedawe (29,1%).Kesimpulan: Prevalensi sarkopenia dan frailty paling banyak ditemukan pada lansia perempuan. Prevalensi sarkopenia paling tinggi didapatkan di desa Serai dan prevalensi frailty didapatkan paling tinggi di desa Pedawe.
Evaluasi derajat delirium sebagai prediktor mortalitas pasien usia lanjut dengan delirium yang dirawat di RSUP Sanglah, Bali, Indonesia Dian Pritasari Jeger; Yosef Samon Sugi; I Gusti Putu Suka Aryana; RA Tuty Kuswardhani; I Nyoman Astika; Ida Bagus Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.687 KB) | DOI: 10.15562/ism.v11i3.830

Abstract

Background: Delirium is an acute attention and cognitive disorder that occurs in elderly patients. The disorder is usually very serious, often goes unrecognized, and is usually fatal. Diagnosis requires a complete cognitive assessment and a history of acute symptoms. Despite the management of the cause, patients with delirium do not always recover. The aim of this study was to determine the correlation between the degree of delirium and the incidence of death in geriatric patients who were admitted to Sanglah General Hospital.Methods: A retrospective cohort study was conducted during November 2014-February 2015 of consecutive patients with delirium aged over 60 years. The degree of delirium was measured by the Memorial Delirium Assessment Scale (MDAS) and Charlson's-Age Comorbidity Index (CACI). These patients were followed periodically and then a bad outcome was determined, namely death while being treated. The association between the severity of delirium and clinical outcome was evaluated using the Pearson test. The results are said to be significant if the p value <0.05 on SPSS version 21 for Windows.Results: The prevalence of delirium in Sanglah General Hospital was mild delirium (48.4%), moderate delirium (28.1%), and severe delirium (23.4%). There was a significant difference in the prevalence of the degree of delirium based on age (p <0.05), but not on gender (p = 0.752). There was a significant difference in the incidence of death based on age (p = 0.045) and degree of delirium (p = 0.01). There was a moderate positive correlation between the degree of delirium and the incidence of death (p = 0.02; r = 0.373).Conclusion: There is a significant relationship between the degree of delirium and the incidence of death in geriatric patients hospitalized in Sanglah General Hospital.  Latar belakang: Delirium merupakan gangguan perhatian dan kognitif akut yang terjadi pada pasien usia tua. Gangguan tersebut biasanya sangat serius, sering tidak dikenali, dan biasanya sangat fatal. Penegakan diagnosis memerlukan penilaian kognitif yang lengkap dan riwayat adanya gejala yang timbul secara akut. Meskipun diberikan penatalaksanaan terhadap penyebabnya, pasien dengan delirium tidak selalu pulih. Tujuan dari penelitian ini adalah untuk menentukan korelasi antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.Metode: Penelitian kohort retrospektif dilakukan selama bulan November 2014-Februari 2015 terhadap pasien dengan delirium yang berusia di atas 60 tahun secara konsekutif. Derajat delirium diukur dengan Memorial Delirium Assesment Scale (MDAS) dan Charlson’s-Age Comorbidity Index (CACI). Pasien tersebut diikuti secara berkala kemudian ditentukan luaran yang buruk yaitu kematian saat dirawat. Hubungan antara derajat keparahan delirium dengan luaran klinis dievaluasi menggunakan uji Pearson. Hasil dikatakan bermakna apabila nilai p<0.05 pada SPSS versi 21 untuk Windows.Hasil: Prevalensi delirium di RSUP Sanglah yakni delirium ringan (48,4%), delirium sedang (28,1%), dan delirium berat (23,4%). Terdapat perbedaan bermakna prevalensi derajat delirium berdasarkan umur (p<0,05), namun tidak pada jenis kelamin (p=0,752). Terdapat perbedaan bermakna pada insiden kematian berdasarkan umur (p=0,045) dan derajat delirium (p=0,01). Terdapat korelasi positif  sedang antara derajat delirium dengan insiden kematian (p=0,02; r=0,373).Kesimpulan: Terdapat hubungan yang signifikan antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.
Correlation between albumin serum and frailty in geriatric inpatient and outpatient clinic at Sanglah Hospital Denpasar Putu Shely Prihastuti Rudy; RA Tuty Kuswardhani; I Gusti Putu Suka Aryana; Nyoman Astika; Ida Bagus Putu Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.51 KB) | DOI: 10.15562/ism.v12i3.1137

Abstract

Background. Frailty in the elderly has a bad impact on health, especially in the elderly  with acute illness. Elderly with frailty has an increase susceptibility to falls, disability and death. Frailty is a common problem in elderly patients, and hypoalbuminemia suggested to increase the risk of death. This study aimed to determine the relationship between albumin and frailty.Method: A Cross-Sectional Study was conducted from February 2018 to January 2019 at Sanglah Hospital with total 60 patients. Patients were divided into two groups, patients with hypoalbuminemia (albumin < 3.5 g/dL) and patients with normal serum albumin levels (albumin ? 3.5 g/dL). The frailty status assessment was measured with Fried's Frailty Phenotype questionnaire. Chi-square test was used to find the relationship between serum albumin and frailty.Result: We evaluated 60 patients, 36 patients (60%) were male and 24 patients (40%) were female. The age of the study subjects ranged from 62 to 92 years. In this study 26 patients (43.3%) with hypoalbuminemia and 34 patients (56.7%) with normal serum albumin. There were 20 patients (76.9%) with frailty in the hypoalbuminemia group, compared to 11 patients (32.4%) in the group of patients with normal serum albumin. Hypoalbuminemia has a risk of 6.97 times greater frailty compared to normal albumin in elderly patients (p = 0.001).Conclusion: This study exhibited a significant relationship between serum albumin and frailty  in elderly admitted to inpatient unit and outpatient clinic. The lower the serum albumin level, the higher the probability of the elderly to experience frailty.
Co-Authors A Santoso Anak Agung Ayu Ratih Hapsari Anak Agung Gede Angga Puspa Negara Anak Agung Mas Putrawati Triningrat Anak Agung Wiradewi Lestari Anwar Santosa Anwar Santoso Aryana, I Gust Putu Suka Astika, I Nyoman Baskoro Tri Laksono Budiana, I Nyoman Catarina Budi P Cilik Wiryani Cok I. I. Purwaningsih Cokorda Agung Wahyu Purnamasidhi Dewianti Dewianti Dewianti, Dewianti Diah Pradnya Paramita Dian Pritasari Jeger Dyah Pradnyaparmita Duarsa Gede Sukrawan I Gusti Agung Wilaja Putra I Gusti Putu Suka Aryana I Ketut Suastika I Made Ady Wirawan I Made Bakta I Made Jawi I Made Jawi I Made Siswadi Semadi I Nyoman Adi Putra I Nyoman Astika I Nyoman Wande I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I Putu Gede Adiatmika I Wayan Mustika I Wayan Mustika I Wayan Mustika I Wayan Wita I. N. Astika I.D. G.A.E. Putra Ida Bagus N Maharjana Ida Bagus Putu Putrawan IGP Adiatmika IN Astika Iswara, Ni Putu Ayu Astri Prana IW Yuna Ariawan J. A. Pangkahila K Andriyasa K Widana Kadek Tresna Adhi Ketut Tirtayasa Lanawati Lanawati, Lanawati M. Ali Imron Made Nopriantha Made Nopy Diah Sundari Muhammad Irfan N Astika N. Adiputra N. K.S. Diniari Ngakan Ketut Wira Suastika, Ngakan Ketut Wira Ni Ketut Rai Purnami Ni Putu Ayu Astri Prana Iswara Ni Wayan Tianing Norlinta, Siti Nadhir Ollin Paramita, Diah Pradnya Purnami, Ni Ketut Rai Purwaningsih, Cok I. I. Putra, I Komang Wisuda Dwija Putu Ayu Indrayathi Putu Ayu Sani Utami Putu Mulya Kharismawan Putu Shely Prihastuti Rudy Rina Listyowati Rina Listyowati, Rina S. Indra Lesmana Saktivi Harkitasari, Saktivi Sawitri, Anak Agung Sagung Semaradana, Wayan Giri Putra Shelvy Florence Gousario Sri Kayati Widyastuti Sundari, Made Nopy Diah Surya Rini, Sandra Susy Purnawati Trisna Yuliharti Tersinanda Wahyuddin, Wahyuddin Wayan Giri Putra Wimpie I Pangkahila Wira Gotera Wirawan, I Made Budi Wisnu Wardhana Yanson - Yosef Samon Sugi