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Zainal R
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Health Professions Medicine & Pharmacology Nursing Public Health

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PROGNOSTIC TEST OF SOFA SCORE WITH THE ADDITION OF LACTATE LEVELS IN PREDICTING 28-DAY MORTALITY OF SEPSIS PATIENTS IN THE INTENSIVE CARE UNIT AT RSMH PALEMBANG Asril A; Zainal R; Irwanto FH; Maritska Z
Majalah Kedokteran Sriwijaya Vol 52, No 3 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i3.12510

Abstract

Sepsis is defined as a life-threatening organ dysfunction caused by the host's unresolved response to infection. Many scoring or biomarkers can be used as a prognostic scoring scoring. Lactate is an indirect measurement of tissue perfusion. SOFA scores and can be applied in predicting independent mortality. Also recently found an increase in SOFA along with an increase in lactate. This study aims to determine the ability of SOFA scores with addition of lactate in predicting mortality in sespsis patients. Observational analytic study with a cross- sectional design using data of sepsis patients treated from January - December 2018 at RSMH Palembang. Inclusion criteria in this study were patients who were treated in intensive care with a diagnosis of sepsis and aged > 18 years with exclusion criteria had incomplete medical record data, referral patients from other hospitals, patients treated less than 24 hours in RSMH Palembang and readmission patients to the intensive unit in the same maintenance period. SOFA scores with additional Lactate levels had a cut-off point of ? 12 with a sensitivity value of 85.0%, specificity: 85.4%, AUC: 92.8%, while the SOFA score had a cut-off point of ?7 with a sensitivity value of 80%, Specificity: 72.9%, AUC: 81.1% in predicting the 28-day mortality of sepsis patients at RSMH Palembang. There was a difference in the prognostic value of the SOFA score with the addition of lactate levels compared to the SOFA score in predicting 28-day mortality of sepsis patients in the intensive care unit of RSMH Palembang.
COMPARISON OF POST OPERATIVE EPIDURAL ANALGESIA EFFECT USING CONTINUOUS 0.125% BUPIVACAINE WITH BOLUS 3 MG MORPHINE ON INSULIN LEVELS IN PATIENT UNDERGOING LOWER LIMB SURGERY Yovalina R; Zulkifli Zulkifli; Zainal R; Erial Bahar
Majalah Kedokteran Sriwijaya Vol 52, No 3 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i3.12511

Abstract

The procedure for lower limb surgery is one of the major and long-standing operations. Surgical trauma stimulates the stress response of surgery. The surgical stress response will interfere with stress hormones including insulin. Insulin is an anabolic hormone that is important in the body and has a role in the process of wound healing. Previous studies have shown insulin levels to correlate with increased surgical stress and the type of anesthesia given. This study analyzed differences insulin levels in bupivacaine 0,125% with morphine 3 mg and to compare the analgesia effect of continuous bupivacaine 0,125% with 3 mg morphine epidural in postoperative lower extremity assessed from insulin levels. A retrospective cohort study taken from secondary data from previous studies and their medical records at RSUP Dr. Mohammad Hoesin Palembang. Statistical analysis used STATA 15th edition. Wilcoxon showed that there was a significant difference in 0,125% bupivacaine group on insulin leves after 12th hours postoperative (p<0.05). Man-Whitney showed that there was no significant difference between the 0,125% bupivacaine with 3 mg morphine on insulin levels postoperative lower extremity after 6th hours, 6th and 12th hours and after 12th hours (p>0.05). In this study, there was no significant difference between the 0,125% bupivacaine with 3 mg morphine on insulin levels
Co-Authors Asril A Erial Bahar Irwanto FH Maritska Z Yovalina R Zulkifli Zulkifli