Siti Setiati
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta

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Geriatric Medicine, Sarkopenia, Frailty, dan Kualitas Hidup Pasien Usia Lanjut: Tantangan Masa Depan Pendidikan, Penelitian dan Pelayanan Kedokteran di Indonesia Siti Setiati
eJournal Kedokteran Indonesia Vol 1, No 3 (2013): Desember
Publisher : Faculty of Medicine Universitas Indonesia

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Geriatri adalah cabang ilmu kedokteran dengan fokus pada penuaan dini dan tatalaksana penyakit terkaitusia lanjut. Proses menua mengakibatkan penurunan fungsi sistem organ seperti sistem sensorik, sarafpusat, pencernaan, kardiovaskular, dan sistem respirasi. Selain itu terjadi pula perubahan komposisitubuh, yaitu penurunan massa otot, peningkatan massa dan sentralisasi lemak, serta peningkatanlemak intramuscular. Masalah yang sering dijumpai pada pasien geriatri adalah sindrom geriatri yangmeliputi: imobilisasi, instabilitas, inkontinensia, insomnia, depresi, infeksi, defisiensi imun, gangguanpendengaran dan penglihatan, gangguan intelektual, kolon irritable, impecunity, dan impotensi. Dimasa yang akan datang diperlukan tempat rawat jalan terpadu dan perawatan kasus akut geriatri dirumah sakit di seluruh Indonesia. Program lainnya adalah nutrisi usia lanjut, tempat istirahat sementara,layanan psiko-geriatri dan dementia care, dukungan care giver, pencegahan penyakit kronis dankonseling, serta menyiapkan moda transportasi yang sesuai.Kata kunci: geriatri, kedokteran, penurunan fungsi, sindrom geriatri.
The prevalence of orthostatic hypotension and its risk factors among 40 years and above adult population in Indonesia Prodjosudjadi, Wiguno; Sutrisna, Bambang; Setiati, Siti
Medical Journal of Indonesia Vol 13, No 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (210.511 KB) | DOI: 10.13181/mji.v13i3.150

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Factors associated with orthostatic hypotension such as age, drug induced hypotension, hypertension and diabetes mellitus have still been debatable. Most of previous studies were conducted in subjects 65 years or older, only a few were done in subjects from younger to older adults. The purpose of this study is to find the prevalence and predictor factors of orthostatic hypotension among adult population aged 40 years and above in Indonesia. This study is a part of Indonesian Hypertension Epidemiologic Survey. A random sample of 4436 subjects aged 40–94 years was obtained from various municipalities in every big island in Indonesia. Orthostatic testing, assesment of history of medical conditions (diabetes mellitus, stroke, and hypertension), blood pressure measurement and use of anti-hypertensive medications were performed. A stepwise logistic regression was used to determine the significant predictor of orthostatic hypotension. A total of 561 persons (12.6%) experienced orthostatic hypotension. Central α2-agonist and other centrally acting drug is the only anti hypertension medicine which influences orthostatic hypotension. Multivariate analysis showed that high systolic and diastolic blood pressures were predictor factors of orthostatic hypotension. The use of anti-hypertensive medicine was a protective factor for orthostatic hypotension. This study confirms the conclusion that age is not a predictor factor for orthostatic hypotension. In fact, the existence of comorbidities in the subjects such as hypertension (high systolic and diastolic blood pressure) is a predictor factor, while the use of anti-hypertensive medication is a protective factor. (Med J Indones 2004; 13: 180-9) Keywords: adult, orthostatic hypotension, prevalence, risk factor
The effect of Ramadhan fasting on kidney function among elderly patients Setiati, Siti; Haricahyo, Suksmono; Rahardjo, Pudji; Hakim, Lukman; Supartondo, Supartondo; Rahardjo, Tri B.W.
Medical Journal of Indonesia Vol 9, No 1 (2000): January-March
Publisher : Faculty of Medicine Universitas Indonesia

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[no abstract available]
Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients Rani, Abdul Aziz; Timan, Ina Susianti; Setiati, Siti; Gunarsa, Ralph Girson; Simadibrata, Marcellus; Syam, Ari Fahrial
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Background: Nowadays, there are still many malnourished patients during hospitalization, which comprises around 45-50% patients. Malnutrition is related to increased mortality and morbidity rate; therefore, nutritional state should be assessed in hospitalized patients. Total lymphocyte count (TLC) is related to decreased body function in malnutrition and it is a means of nutritional assessment. Until now, there is no data showing association between malnutrition and TLC in hospitalized patients in Indonesia. The objective of this study was to identify the association between malnutrition and TLC < 1,200 cell/mm3 in hospitalized patients. Method: This study was a cross-sectional study. Subjects were new patients hospitalized at internal medicine ward of Cipto Mangunkusumo Hospital. Patients were collected by consecutive sampling. We conducted the study between April and May 2008. Fifty four patients were assessed for malnutrition by the subjective global assessment (SGA) and they also had undergone complete blood count. TLC was numbered with routine complete blood count test. Patients were classified into malnutrition according to SGA. TLC was classified with cut-off point of 1,200 cell/mm3. Statistical analysis included Chi-square test, which was used to compare proportion. Results: There were 52% malnourished patients, 33% patients with TLC < 1,200 cell/mm3, 57% patients with malnutrition and TLC < 1,200 cell/mm3. This study showed that there was an association between malnutrition and TLC < 1,200 cell/mm3 (p = 0.001). Moreover, there was also significant association between severe malnutrition (SGA C) with TLC < 900 cell/mm3 (p = 0.02). Conclusion: There is an association between malnutrition and TLC < 1,200 cell/mm3.   Keywords: malnutrition, total lymphocyte count, body mass index, subjective global assessment
Proportion and Factors Associated with Zinc Deficiency in Acute Diarrhea Patients Setiati, Siti; Simadibrata, Marcellus; Oto, Budi Tan; Dillon, Drupadi Harnopidjati Singh
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/122201172-78

Abstract

Background: Zinc may affect the intestinal immune response. No data has been available on zinc deficiency in adult patients with diarrhea, especially for Indonesian population. Zinc metabolism, etiologies, pathogenesis and clinical course of diarrhea may have various effects on zinc concentration in different population. This study aimed to determine the proportion of zinc deficiency in patients with acute diarrhea, including its associated factors. Method: A cross-sectional study was conducted in patients with acute diarrhea at outpatient clinics and emergency wards of four hospitals between August 2010 and March 2011. A serum zinc concentration of < 10.7 µmol/L was set as cut-off value for zinc deficiency. Data was analyzed by using Chi-square test. Results: There were 101 subjects, 54.5% were female, the median age was 26 years, median duration of acute diarrhea was 5 days, and the median frequency was 6 times/day. About 95% patients had nutritional status of subjective global assessment (SGA) A and the mean value of body mass index was 19.3 ± 0.70 kg/m2. Approximately 88.1% patients had severe infective diarrhea based on hydration status. About 69.3% patients were zinc deficient with the mean serum zinc concentration of 9.26 ± 2.95 µ mol/L. We found a significant correlation between the severity of diarrhea and zinc deficiency in patients with acute diarrhea. Conclusion: The proportion of zinc deficiency in acute diarrhea patients was quite large although the mean serum zinc level was still below the National Health and Nutrition Examination Survey (NHANES) reference value. The severity of diarrhea has been proven to be significant that affects zinc deficiency in acute diarrhea patients. Keywords: zinc deficiency, acute diarrhea, adult
The Effect of Branched Chain Amino Acids and L-Ornithine L-Aspartate Combination as The Late Evening Snacks on Nutritional Status and Minimal Hepatic Encephalopathy in Liver Cirrhosis Hasan, Irsan; Setiati, Siti; Sanityoso, Andri; Tenda, Eric Daniel
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/1332012151-156

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ABSTRACTBackground:Minimal hepatic encephalopathy (MHE) in liver cirrhotic patients is critical manifestation of low grade hepatic encephalopaty (HE), is caused quality of life decrease and risk of deteriorating into distinct HE. The study was conducted to asses the effect of combination of branched-chain amino acids (BCAA) and L-ornithine L-aspartate (LOLA), which was given late evening, on nutritional status and degree of HE.Method: This single-blind randomized study was conducted on liver cirrhotic outpatients in hepatology clinic of Cipto Mangunkusumo Hospital period June 2011-June 2012. The study subjects were divided into two groups, group of late evening snack (LS) and day snack (DS). Each group was supplemented with combination of milk of BCAAs and LOLA (3.7 g/serving). Evaluation based on history, physical examination, laboratory tests and critical flicker frequency (CFF) was performed one month after the intervention. Data were statistically analyzed with SPSS 15.Results: Thirty-two patients whose the inclusion criteria were divided into 16 subjects for each group, LS and DS. After one month of the intervention, the average level of prealbumin for DS group was increased statistically significant (p < 0.001), but not significant for LS group (p = 0.259). The increase of average body weight,mid-arm muscle circumference (MAMC) and CFF test result in both groups. There was no improvement on subject global assessment (SGA) score after one month intervention in both groups.Conclusion: This study proved that giving combination of BCAAs and LOLA may improve the condition of MHE, however for nutritional status can not be assessed. Keywords: minimal hepatic encephalopathy, BCAAs, LOLA, prealbumin, SGA score, nutritional status
KEJADIAN REAKSI OBAT YANG TIDAK DIKEHENDAKI YANG MENYEBABKAN PASIEN USIA LANJUT DIRAWAT DI RUANG PERAWATAN PENYAKIT DALAM INSTALASI RAWAT INAP B RUMAH SAKIT DR. CIPTO MANGUNKUSUMO Merry Christianie; Siti Setiati; Yulia Trisna; Retnosari Andrajati
Pharmaceutical Sciences and Research (PSR) Vol 5, No 3 (2008)
Publisher : Directorate of Research and Community Engagement, Universitas Indonesia

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Objectives. To determine the prevalence of adverse drug reaction related hospital ad-missions in geriatric patients, to describe the most frequent clinical manifestationsand the drugs responsible to adverse drug reaction related hospital admissions.Design. Observational cross-sectional study.Methods. Naranjo algorithm used to assess the adverse drug reaction causality.Subjects and setting. Geriatric patients admitted to geriatric inpatient installation of Cipto Mangunkusumo general hospital over one month period and assessed for cause of admissions.Results. 14,7% of 102 admissions were identified to be adverse drug reaction related hospital admissions. One adverse drug reaction was categorized as definite and 14 were probable causality. Gastrointestinal bleeding and hypoglicemia were the most common clinical manifestation found. The drugs most frequent responsible for these adverse drug reactions were nonsteroidal antiinflamatory drugs and oral antidiabeticdrugs.Conclusion. Adverse drug reactions are an important cause of hospital admission in geriatric patients.Keywords: adverse drug reaction, geriatric, Naranjo algorithm.
Kesintasan Lima Tahun Pasien Penyakit Jantung Koroner Tiga Pembuluh Darah dengan Diabetes Melitus yang Menjalani Bedah Pintas Koroner, Intervensi Koroner Perkutan atau Medikamentosa di Rumah Sakit dr. Cipto Mangunkusumo Setiawan, Andreas Arie; Panggabean, Marulam; Yamin, M; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol 3, No 2 (2016)
Publisher : Jurnal Penyakit Dalam Indonesia

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Pendahuluan. Hasil revaskularisasi pada pasien diabetes melitus (DM) dengan penyakit jantung koroner 3 pembuluh darah (PJK 3PD) dengan bedah pintas koroner (BPK) lebih baik dibandingkan intervensi koroner perkutan (IKP) atau medikamentosa. BPK tidak selalu menjadi prosedur yang dikerjakan meskipun sudah direkomendasikan sesuai Skor Syntax. Selain itu, tidak semua pasien bersedia menjalani BPK atau IKP. Perlu diketahui apakah pilihan revaskularisasi tersebut mempengaruhi kesintasan 5 tahun.Metode. Penelitian ini merupakan studi kohort retrospektif dengan pendekatan analisis kesintasan untuk meneliti kesintasan 5 tahun pasien PJK 3PD DM yang menjalani tindakan BPK, IKP atau medikamentosa. Penelitian dilakukan dengan menggunakan data sekunder 126 pasien PJK 3PD DM yang menjalani BPK, IKP, maupun medikamentosa di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada tahun 2006-2007 dan diikuti sampai dengan tahun 2011-2012 dengan dilihat adakah kejadian meninggal.Hasil. Kesintasan terbaik diketahui yaitu pada kelompok BPK (93,5%). Proporsi kematian terbesar terdapat pada kelompok medikamentosa (36,1%). Selain itu, hasil analisis menunjukkan bahwa kelompok IKP memiliki kesintasan yang lebih baik dibanding medikamentosa (69,5% vs 63,9%). Meskipun tidak bermakna secara statistik, namun pada kelompok IKP proporsi keluhan yang ditemukan setelah tindakan lebih sedikit dibanding kelompok medikamentosa (52% vs 38%). Skor Syntax yang berperan menilai kompleksitas stenosis diketahui turut menentukan kesintasan (p=0,039).Simpulan. Kesintasan 5 tahun pasien PJK 3PD dengan DM yang paling baik didapatkan pada kelompok yang menjalani BPK. Kesintasan 5 tahun pasien PJK 3PD dengan DM yang menjalani IKP lebih baik dibandingkan medikamentosa, namun secara statistik tidak bermakna. Faktor yang berpengaruh pada kesintasan 5 tahun pasien PJK 3PD adalah kompleksitas stenosis yang dilihat dengan menggunakan skor Syntax.Kata kunci: DM, kesintasan 5 tahun, PJK 3PD Five-Year Survival in Patients with 3-Vessels Coronary Artery Disease and Diabetes Mellitus Undergoing Coronary Artery Bypass Graft, Coronary Percutaneus Intervention, or Receiving Pharmacological Therapy in Cipto Mangunkusumo HospitalIntroduction. Revascularization results in patients with diabetes mellitus (DM) and coronary artery disease involving 3 vessels (CAD 3VD) undergo coronary artery bypass surgery (CABG) are better compared with those undergo percutaneous coronary intervention (PCI) or medical therapy. However, CABG is not always done despite being recommended in accordance with Syntax Score because some patients unwilling to undergo CABG or PCI . This trial determined whether the choice of revascularization affect 5-years survival. Methods. This was a retrospective cohort study with survival analysis to examine the 5-years survival rate of CAD 3VD DM patients undergoing CABG, PCI, or medical therapy. The study was conducted using secondary data of 126 CAD 3VD DM patients who underwent CABG, PCI, or medical therapy at Cipto Mangunkusumo Hospital in 2006-2007 and followed up to 2011-2012 if there any incident died. Results. Best survival was seen in the CABG group (93.5%). The largest proportion of death occured in the medical therapy group (36.1%). The CABG survival was significantly better than the IKP (p=0.01) and medical therapy (p=0.001). PCI group had better survival than medical therapy (69.5% vs. 63.9%). Although not statistically significant, but the proportion of complaints after revascularization in PCI group were found less than medical therapy group (52% vs. 38%). Syntax score that assesses the complexity of stenosis had a significant association with survival (p 0.039). Conclusions.5-years survival of CAD 3VD DM patients is best obtained in the group that underwent CABG. 5-year survival of CAD 3VD DM patients who underwent PCI better than medical therapy but was not statistically significant. Factor that affect the 5-years survival is the complexity stenosis viewed by the Syntax score. Keywords: 5-years survival, CAD 3VD,DM
Prevalensi dan Faktor Prediktor Atopi pada Pasien HIV/AIDS Prevalence and Predictors of Atopy in HIV/AIDS Patients Tesiman, Jimmy; Sundaru, Heru; Karjadi, Teguh H; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol 3, No 2 (2016)
Publisher : Jurnal Penyakit Dalam Indonesia

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Pendahuluan. Infeksi HIV menyerang pusat kontrol dari sistem imun yang mengakibatkan terjadinya infeksi opportunistik, keganasan dan kematian. Disregulasi dari sistem imun memegang peranan penting dalam progresifitas penyakit HIV. Beberapa penelitian melaporkan bahwa pasien-pasien HIV mempunyai kecenderungan untuk menderita penyakit alergi seperti sinusitis, asma dan dermatitis atopik. Juga dilaporkan terjadinya peningkatan kadar serum imunoglobulin E (IgE) dan peningkatan prevalensi atopi.Metode. Studi potong lintang dilakukan pada 92 orang terinfeksi HIV dan 90 orang non-HIV. Adanya atopi dinyatakan berdasarkan pemeriksaan uji tusuk kulit dengan menggunakan enam macam aeroalergen yang umum di lingkungan. Terhadap pasien-pasien yang sudah didiagnosis dengan HIV dilakukan pemeriksaan kadar IgE total, jumlah limfosit CD4 serta anamnesis terkait.Hasil. Dari 92 orang dengan infeksi HIV/AIDS dan 90 orang non-HIV yang diteliti, terdiri 65 laki-laki (70,7%) dan 27 perempuan (29,3%) pada kelompok HIV, sedangkan pada kelompok non-HIV terdiri atas 40 laki-laki (44,4%) dan 50 wanita (55,6%). Umur subjek penelitian berkisar antara 20-55 tahun dengan rerata 29,3 (5,7) tahun pada kelompok HIV, sedangkan rerata kelompok umur kontrol adalah 27,9 (4,5) tahun. Berdasarkan rute transmisi HIV, didapatkan sebanyak 52 subjek melalui penggunaan obat intravena (56,5%), 35 melalui hubungan seksual (38%) sedangkan sisanya (5,5%) mempunyai risiko keduanya. Jumlah limfosit CD4+ berkisar 2-674 sel/uL dengan median 160 sel/uL. Kadar IgE total berkisar dari 3-20.000 IU/ mL dengan median 283,5 IU/mL. Kejadian atopi lebih tinggi pada subjek dengan HIV dibandingkan dengan kelompok non-HIV (p= 0,001). Aeroalergen tersering yang menimbulkan sensitasi adalah Dermatophagoides farinae sebanyak 50% dan Dermatophagoides pteronyssinus sebanyak 30%. Didapatkan adanya korelasi negatif yang bermakna antara jumlah limfosit CD4+ dengan kadar IgE total (r=-0,544, p<0,001). Namun demikian, tidak didapatkan hubungan yang bermakna antara jenis kelamin, rute transmisi, riwayat alergi di keluarga serta jumlah limfosit CD4+ dengan kejadian atopi.Simpulan. Prevalensi atopi pada pasien HIV/AIDS berdasarkan uji tusuk kulit lebih tinggi dibanding kelompok non-HIV. Terdapat korelasi negatif antara kadar IgE total dengan jumlah limfosit CD4+.Kata kunci: atopi, HIV, tes tusuk kulitPrevalence and Predictors of Atopy in HIV/AIDS PatientsIntroduction. HIV infection attacks the center of immune control system resulting opportunistic infection, malignancy and death. Immune system dysregulation plays the central role in the progression of the disease. Some studies reported that HIV-infected patient prone to have allergic disease such as sinusitis, asthma and atopic dermatitis. Elevated serum immunoglobulin E (IgE) and increased prevalence of atopy had also been reported in HIV-infected patient. Methods. A cross sectional study was performed in 92 HIV-infected persons and 90 non-HIV persons. Atopy diagnosis was based on immediate hypersensitivity to six common aeroallergen using skin prick test. CD4 cell count, total serum immunoglobulin level and medical history were taken. Results. Among total of 92 HIV/AIDS patients and 90 non-HIV persons, there were 65 males (70.7%) and 27 female (29.3%) in HIV group and 40 males (44.4%) and 50 females (55.6%) in non-HIV group. Age of all subjects range from 20 to 55 years old, mean age of HIV-infected patients was 29.3 (SD 5.7) years while mean age of controls was 27.9 (4.5) years old. Based on HIV route transmission, there were 56.5% subjects infected from intravenous drug user, 38% from heterosexual intercourse and 5.5% subjects had both risk. CD4+ lymphocyte counts of the subject range from 2-674 cells, median 160 cells/uL. Serum total IgE levels range from 3-20.000 IU/mL with median 283.5 IU/mL. Atopy was higher in subjects with HIV than non-HIV (p= 0,001). The most common aeroallergen is Dermatophagoides farinae (50%) and Dermatophagoides pteronyssinus (30%). There was a negative correlation between CD4+ lymphocyte count and total IgE level (r=-0,544, p<0,001), but there is no relation between gender, HIV route of transmission, allergic history in family and CD4+ lymphocyte count with atopy. Conclusions. Prevalence of atopy based on skin prick test among HIV/AIDS patients was higher than non-HIV group. There was a negative correlation between CD4+ lymphocyte count and total IgE level. Keywords: atopy, CD4, HIV, IgE
Faktor-Faktor yang Berhubungan dengan Mortalitas 30 Hari pada Pasien Sakit Kritis dengan Kandidiasis Invasif yang Dirawat di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM) Ardian, Ardi; Pitoyo, Ceva W; Adhitianingsih, Dita; Santoso, Widayat Djoko; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol 4, No 1 (2017)
Publisher : Jurnal Penyakit Dalam Indonesia

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Pendahuluan. Tingkat mortalitas kandidiasis invasif mencapai 30-70%. Setiap studi menunjukkan tingkat mortalitas yang berbeda pada studi dan sampel yang berbeda. Belum ada data mengenai profil dan analisis faktor mortalitas kandidiasis invasif pada pasien sakit kritis. Studi ini bertujuan untuk memberikan informasi profil kandidiasis invasif pada pasien sakit kritis beserta faktor faktor yang berpengaruh terhadap mortalitas sebagai upaya untuk meningkatkan kualitas tata laksana pasien sakit kritis dengan kandidiasis invasif.Metode. Desain penelitian adalah potong lintang, mengumpulkan data dari rekam medis pada seratus dua pasien sakit kritis dengan kandidiasis invasif. Pasien kandidiasis invasif adalah pasien dengan hasil kultur darah dan atau kultur cairan tubuh normal steril positif jamur spesies Candida. Data yang dikumpulkan meliputi data usia, spesies jamur candida penyebab, faktor risiko kandidiasis invasif, serta data faktor yang berpengaruh terhadap mortalitas yang meliputi ada tidaknya kondisi sepsis, nilai APACHE, ada tidaknya kondisi gagal napas,ada tidaknya gagal ginjal, waktu pemberian terapi antijamur,Charlson Index, dan tempat perawatan (ICU atau Non ICU). Uji analisis bivariat dengan uji chi square dilakukan terhadap masing masing faktor, yang dilanjutkan dengan uji multivariat regresi logistik untuk menilai faktor yang paling berhubungan terhadap mortalitas 30 hari.Hasil. Dari 102 sampel penelitian didapatkan laki laki 52,9% dan perempuan 47,1%. Median usia 53 tahun dengan angka mortalitas 68,6%. Spesies candida penyebab terbanyak adalah Candida tropicalis (34,3%) dan Candida parapsilosis (29,4%), tiga faktor risiko kandidiasis invasif terkait penyakit dasar adalah sepsis (78,9%), keganasan (42,15%), diabetes melitus ( 29,4%) sedangkan yang terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas (99%), kateter vena sentral (77,5%), serta pemberian nutrisi parenteral (70,6%). Pada analisis multivariat regresi logistik, faktor yang paling berpengaruh terhadap mortalitas adalah sepsis berat ( p 0,001, OR 7,7, IK95% 2,4 – 24,7), Charlson Index ≥ 3 ( p 0,022, OR 3,5, IK95% 1,2 – 10,2), dan gagal napas (p 0,066, OR 2,733 IK95% 0,9 – 8,0).Simpulan. Pada pasien sakit kritis dengan kandidiasis invasif yang dirawat di RSCM, laki laki lebih banyak dari pada perempuan, dengan median usia 53 tahun, dan angka mortalitas 68,6%. Spesies candida terbanyak penyebab infeksi adalah Candida tropicalis dan Candida parapsilosis. Faktor risiko kandidiasis invasif terbanyak terkait penyakit dasar adalah sepsis sedangkan terkait terapi atau tata laksana adalah penggunaan antibiotik spektrum luas. Faktor faktor yang berhubungan dengan mortalitas 30 hari adalah kondisi sepsis berat dan Charlson index ≥3.Kata Kunci: faktor mortalitas, kandidiasis invasif, sakit kritis Factors Related to 30 day Mortality in Critically Ill Patients with Invasive Candidiasis in Cipto Mangunkusumo HospitalIntroduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such as age > 60 years old, severe sepsis, APACHE score > 20, respiratory failure, renal failure, delayed antifungal treatment > 72 hours after positive culture, Charlson index score, and ICU or non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Results. Among 102 identified sample, the majority was male (52.9%), the median age was 53 years old and the mortality rate was 68,6%. Laboratory candida findings came from blood sample (candidemia) (98.03%), liquor cerebrospinal (1.5%) and retina exudate (1.5%). The most common candida species were candida non albicans especially Candida tropicalis (34.3%) and Candida parapsilosis (34.3%). The risk factors for invasive candidiasis from this study related to underlying disease were sepsis (78.9%), malignancy (42.15%), diabetes mellitus (29.4%) and related to therapy or treatment were the usage of broad spectrum antibiotic (99%), central vein catheter (77.5%), and parenteral nutrition (70.6%). The result from multivariate analysis, severe sepsis (p 0.001, OR 7.7, IK95% 2.4 – 24.7), Ch arlson Index ≥3 (p 0.022, OR 3.5, IK95% 1.2–10.2), and respiratory failure (p 0.066, OR 2.7 IK95% 0.9 – 8.0) were independently associated with mortality. Conclusions. In Cipto Mangunkusumo hospital, most critically ill patients with invasive candidiasis was male, median age was 53 years old, and mortality rate was 68,6%. The most species candida caused infection were Candida tropicalis and Candida parapsilosis. The most risk factors of invasive candidiasis from underlying disease was sepsis and from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ≥3 were associated with a 30 day mortality in critically ill patients with invasive candidiasis.
Co-Authors Abdul Aziz Rani Aida Lydia, Aida Alimuddin, Suriani Alvina Widhani, Alvina Andreas Arie Setiawan, Andreas Arie Andri Sanityoso Ardi Ardian, Ardi Ari F Syam Ari Fahrial Syam Arya Govinda Roosheroe, Arya Govinda Aulia Rizka, Aulia Ayatullah Khomaini Bambang Setyohadi Bambang Sutrisna Budi I Santoso, Budi I Budi Tan Oto Catarina Budyono, Catarina Ceva W Pitoyo CHAIDIR A MOCHTAR, CHAIDIR A Cleopas M Rumende, Cleopas M Dadang Makmun Dharmeizar Dharmeizar Diana, Nyimas Dita Adhitianingsih, Dita Djumhana Atmakusuma, Djumhana Drupadi Harnopidjati Singh Dillon Dyah Purnamasari Edy Rizal Wahyudi Em Yunir, Em Eric Daniel Tenda Esthika Dewiasty, Esthika Euphemia Seto, Euphemia Findy Prasetyawaty, Findy Firtantyo A Syahputra, Firtantyo A Ginova Nainggolan Harrina E Rahardjo, Harrina E Harry Isbagio Herikurniawan, Herikurniawan Heru Sundaru Idrus Alwi Ika P Wijaya, Ika P Ika Prasetya Wijaya, Ika Prasetya Ina Susianti Timan Indra G Mansur, Indra G Iris Rengganis Irsan Hasan Jimmy Tesiman, Jimmy Joedo Prihartono Junizaf Junizaf Kuntjoro Harimurti Laura A Siahaan, Laura A Lugyanti Sukrisman Lukman Hakim M Sadikin M Yamin Marcel Prasetyo Marcellus Simadibrata Martini, Rose D Marulam Panggabean, Marulam Meilania Saraswati Merry Christianie Merry Christianie, Merry Muhammad Yamin Mulyana, Roza Murdani Abdullah Nadia Ayu Mulansari, Nadia Ayu Nafrialdi Nafrialdi Nanang Sukmana Noto Dwimartutie Nur Riviati, Nur Partini P Trihono, Partini P Pradana Soewondo Pudji Rahardjo Purwita W Laksmi, Purwita W Purwita Wijaya Laksmi Rachmat Hamonangan, Rachmat Radhiyatam Mardhiyah, Radhiyatam Ralph Girson Gunarsa Retnosari Andrajati Rino A Gani Rochani Sumardi, Rochani Rudy Hidayat Saraswati, Mita Hafsah Simon Salim Siti A Nuhonni, Siti A Stevent Sumantri, Stevent Suksmono Haricahyo Supartondo Supartondo Teguh H Karjadi, Teguh H Tirza Z Tamin Tities Anggraeni Indra, Tities Anggraeni Tri B.W. Rahardjo vera vera, vera Vidhia Umami, Vidhia Wasilah Rochmah Widayat Djoko Santoso, Widayat Djoko Wiguno Prodjosudjadi Wijaya, Indra Wulyo Rajabto Yulia Trisna Yulia Trisna, Yulia