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Agustinus I Wayan Harimawan

Department Of Clinical Nutrition, Faculty Of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia.

Author-ID : 772454

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Nursing Public Health

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Kajian metode Subjective Global Assessment (SGA) dan Nutrition Services Screening Assesment (NSSA) sebagai status gizi awal pasien dewasa sebagai prediktor lama rawat inap dan status pulang Agustinus I Wayan Harimawan; Hamam Hadi; Susetyowati Susetyowati
Jurnal Gizi Klinik Indonesia Vol 7, No 3 (2011): Maret
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.17750

Background: Assessment of nutrition status of newly hospitalized patients is an initial stage of nutrition intervention which will bring effects to the duration of stay and the history of patients' diseases during hospitalization. Appropriate nutrition intervention as part of patients' care can be used as an indicator of the quality of hospital service.Objective: The study aimed to identify preliminary nutrition status of newly hospitalized adult patients using SGA method, its effects to length of stay and status of discharge and compare the capacity of SGA and NSSA indicators in predicting length of stay and status of discharge of adult patients.Method: This observational study used prospective cohort study design. It was carried out at Anuntaloko Hospital of Parigi, District of Parigi Moutong, Sulawesi Tengah from July to September 2008. Subject consisted of 162 people comprising 82 undernourished people and 80 people with good nutrition status based on assessment using SGA method. Data analysis used bivariable and multivariable, receiver operating characteristics (ROC) curve and diagnostic methods using computer program.Result: The majority of newly hospitalized patients were undernourished (50.6%); preliminary status of patients assessed using SGA method could affect length of stay, relative risk (RR)=3.67 but not status of discharge (RR=0.97). The capacity of SGA indicator, area under the curve (AUC)=0.81 and maximum sum of sensitivity and specifcity (MSS) =1.57 was better than NSSA indicator (AUC=0.76 and MSS 1.43) in predicting length of stay. The capacity of SGA indicator (AUC=0.50 and MSS=1.01) was better than NSSA indicator (AUC=0.49 and MSS=0.98) in predicting discharge status of the patient.Conclusion: SGA and NSSA indicators could be implemented in assessing preliminary nutrition status of newly hospitalized adult patients; SGA indicator had better capacity than NSSA indicator.

Correlation of glutamine and serial absolute neutrophil count as a parameter of infection in major burn trauma patients at Sanglah General Hospital, Bali, Indonesia Shita Diwyani Sudarsa; Agus Roy Rusly Hariantana Hamid; Agustinus I Wayan Harimawan; Ni Nyoman Sri Budayanti
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Burns are thermal trauma that often results in high morbidity. In major burns, gastrointestinal dysfunction plays a vital role in the progression of infection to organ failure. Glutamine is a pharmaconutrient that has important implications for burn patients, including in the prevention of infection. This study evaluates the relationship between glutamine administration and the serial absolute neutrophil count as a parameter for infection incidence in patients with major burns.Methods: This study was an analytical study with a cross-sectional design to see the relationship between glutamine administration and the serial absolute neutrophil count levels of major burn patients at Sanglah General Hospital. The sample consisted of 56 patients from the medical records of burn patients. The data were extracted from the medical records and then inserted into the data collection sheet. Then performed data analysis using SPSS version 21 for Windows.Results: Bivariate analysis showed that there was a significant difference between glutamine administration and the absolute neutrophil count levels on days 3, 5, and 14 (p = 0.004, 95% CI: 1.70-8.46), (p = 0.000, 95% CI: 2.71-7.83), and (p = 0.035, 95% CI: 0.61-7.27), respectively. This showed that patients given glutamine had lower neutrophil levels on days 3, 5, and 14 than patients who were not given glutamine. Multivariate analysis confirmed that glutamine administration did independently affect and decrease the absolute neutrophil count levels on days 3, 5, 14, and the mean without being influenced by other variables with p value = 0.004 (95% CI: [-8.445] - [-1,732]), p = 0.000 (95% CI: [-7,808]-[-2,743]), p = 0.020 (95% CI: [-7.251]-[-0.639]), and p = 0.017 (95% CI: [-5,815]-[-0.588]), respectively.Conclusion: This study has shown that glutamine administration was significantly associated with and decreased the serial absolute neutrophil count in major burn patients.

Kadar Urine Urea Nitrogen (UUN) sebagai prediktor mortalitas pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah Denpasar Grace Inriani Rongre; I Gusti Putu Hendra Sanjaya; Agustinus I Wayan Harimawan; Sianny Herawati
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Background: Urine urea nitrogen (UUN) is an examination of nitrogen balance with the concept of calculating the amount of urea excreted through urine. The amount of urea that comes out of the urine is in line with the amount of protein breakdown in the body and the amount of protein that enters the body. This study aimed to evaluate UUN levels on days 1, 3 and 7 as a predictor of mortality in burn patients >20%. Methods: This study was an observational analytic retrospective study. Data were collected from January 2020 to December 2021. This study used secondary data from medical records of patients with IIAB-III degree burns with burn area > 20% TBSA treated at Prof. Dr. I. G. N. G. Ngoerah General Hospital for 2020-2021. Data were analyzed using SPSS version 21 for Windows. Results: The majority of burn patients were male, about 73.9%. The average age of burn patients is 48.26±15.95 years. On the first examination day, the UUN value was still low (29.4 mg/24 hours). Then on the 3rd day, there was an increase in the average UUN level, namely the maximum value of 61,987 mg/24 hours. Examination on the 7th day showed an increase in line with the previous day, namely the maximum value of 57,489 mg/24 hours. On day 1, the mean UUN value was higher in patients who died, while on days 3 and 7 the mean UUN level in patients with living outcomes was higher than in patients who died, but not significantly (p>0.05). Conclusion: Urine urea nitrogen levels on days 1, 3 and 7 in burn patients >20% at Prof. Dr. I. G. N. G. Ngoerah General Hospital showed an increasing trend. Urine urea nitrogen levels cannot be used to predict mortality in burn patients because the results were insignificant. Latar Belakang: Urin urea nitrogen (UUN) merupakan pemeriksaan keseimbangan nitrogen yang berkonsep pada perhitungan jumlah urea yang dieksresikan lewat urin. Jumlah urea yang keluar bersama urine sejalan dengan jumlah pemecahan protein dalam tubuh serta jumlah protein yang masuk dalam tubuh. Penelitian ini bertujuan untuk mengevaluasi kadar UUN hari ke-1,3, dan 7 sebagai prediktor mortalitas pasien luka bakar >20%. Metode: Studi ini merupakan studi retrospektif analitik observasional. Data dikumpulkan dari Januari 2020 hingga Desember 2021. Studi ini menggunakan data sekunder dari catatan rekam medis pasien luka bakar derajat IIAB-III dengan luas luka bakar > 20% TBSA yang dirawat di RSUP Prof. Dr. I. G. N. G. Ngoerah periode 2020-2021. Data dianalisis dengan SPSS versi 21 untuk Windows. Hasil: Mayoritas pasien luka bakar berjenis kelamin laki-laki yaitu sebesar 73,9%. Usia rata-rata pasien luka bakar yaitu 48,26±15,95 tahun. Pada pemeriksaan hari pertama didapatkan nilai UUN masih rendah (29,4 mg/24 jam). Kemudian pada hari ke-3 didapatkan peningkatan rata-rata kadar UUN yakni nilai maksimum 61.987 mg/24 jam. Pemeriksaan pada hari ke-7 menunjukkan peningkatan yang sejalan dengan hari sebelumnya yakni nilai maksimum 57.489 mg/24 jam. Pada hari ke-1, nilai rerata UUN lebih tinggi pada pasien meninggal, sedangkan pada hari ke 3 dan 7 kadar rerata UUN pasien dengan luaran hidup lebih tinggi dibandingkan pasien yang meninggal, namun tidak bermakna secara signifikan (p>0,05). Simpulan: Kadar UUN pada hari ke-1, 3 dan 7 pada pasien luka bakar >20% di RSUP Prof. Dr. I. G. N. G. Ngoerah menunjukkan adanya trend peningkatan. Kadar UUN tidak dapat dipakai sebagai prediktor mortalitas pada pasien luka bakar karena hasil tidak signifikan.

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