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Pengaruh Heart Rate Variability terhadap Kesintasan Pasien dengan Kanker: Laporan Kasus Berbasis Bukti Kosasih, Kartika Anastasia; Raniah, Nida; Putranto, Rudi; Rajabto, Wulyo; Shatri, Hamzah; Faisal, Edward; Poespitasari, Vinandya Irvianita
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Depression, anxiety, and poor outcomes in cancer are possibly mediated by autonomic dysfunction. Autonomic disfunction found in cancer patients can cause increase in sympathetic tone and decrease in cardiac muscle vagal tone. Heart rate variability (HRV) is a non-invasive index for measuring vagal response and a potential stress response in autonomic dysfunction. In patients with cancer, high vagal tone measured by HRV is significantly correlated with increased overall survival. This evidence-based case report aims to investigate the role of HRV as a prognostic factor in cancer patients. Literature search was done by two authors on five databases: Pubmed, Cochrane Library, EMBASE, ProQuest dan MEDLINE (EbscoHost) in accordance with clinical question. Articles were selected using inclusion and exclusion criteria, then critical review was performed. Quality of the studies was evaluated using the Center of Evidence-Based Medicine, University of Oxford guideline. Two systematic review and four cohort study was included. Increased HRV index is consistently correlated with increased overall survival (OS) in cancer patients. One meta-analysis study found that OS is significantly longer in group with higher HRV (Hazard ratio, HR = 0.70, IK95% 0.60 – 0.82, p < 0.001, I2 = 27%). In conclusion, HRV can be used as a prognostic factor in advanced stage cancer patients. Increased HRV is associated with better OS.
Effects of Early Hospital-Based Palliative Care Consultation on Length of Stay and Costs of Care at Indonesian Tertiary Hospital Putranto, Rudi; Shatri, Hamzah; Rajabto, Wulyo; Sumariyono, Sumariyono; Faisal, Edward; Sihwastuti, Sihwastuti
Kesmas Vol. 18, No. 3
Publisher : UI Scholars Hub

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Abstract

Despite the numerous benefits of palliative care for cancer patients, there have been few studies on palliative care services for terminal cancer patients, particularly near the end of life. This study aimed to evaluate whether there were differences in length of stay and cost of care associated with how early or late a patient received palliative care intervention. Another objective was to compare the length of stay and cost of care of those who received palliative care intervention and those who did not. This study used a cohort retrospective design at Hospital A, Jakarta, Indonesia, from January to December 2019. The diagnosis of terminal cancer was based on medical records. Data on length of stay and costs of care were based on medical records and finance billing. The hospitalized terminal cancer patients (392) were recruited by consecutive sampling. The length of stay and costs of care for patients with advanced cancer who received palliative care consultations were longer and higher than for patients who did not receive them. However, if palliative care consultation is provided early, the increase in length of stay and costs are less.
Peran heart rate variability dan faktor inflamasi pada sindrom lelah kronik Anwar, Bariani; Faisal, Edward; Irvianita, Vinandia; Putranto, Rudi; Shatri, Hamzah
Indonesian Journal of Health Science Vol 4 No 6 (2024)
Publisher : PT WIM Solusi Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54957/ijhs.v4i6.1139

Abstract

Sindrom kelelahan kronis yang juga dikenal sebagai Myalgic Encephalomyelitis (ME), adalah kondisi kronis kompleks yang ditandai oleh kelelahan parah, disertai nyeri muskuloskeletal, gangguan kognitif, dan sistem autonom. Patofisiologi CFS melibatkan inflamasi kronis, disfungsi mitokondria, dan ketidakseimbangan sistem kekebalan, yang ditunjukkan dengan tingginya kadar sitokin pro-inflamasi. Aktivitas sitokin ini berperan dalam munculnya gejala utama seperti kelelahan, nyeri, dan penurunan kognitif. Diagnosis CFS merupakan proses yang kompleks karena didasarkan pada metode eksklusi dan belum adanya biomarker definitif sehingga menyebabkan banyak pasien tidak terdiagnosis. Heart Rate Variability (HRV) telah diajukan sebagai metode non-invasif untuk menilai disfungsi autonom pada CFS, di mana HRV rendah menunjukkan peningkatan risiko kelelahan dan disfungsi parasimpatis. Penggunaan HRV dan sitokin sebagai biomarker potensial menawarkan pendekatan yang lebih terukur dalam mendiagnosis CFS serta memprediksi prognosis. Namun, heterogenitas dalam hasil penelitian terkait peran sitokin menekankan pentingnya konsistensi metodologis di masa mendatang. Studi lanjutan tentang HRV dan inflamasi pada CFS diharapkan dapat berkontribusi pada strategi terapi yang lebih spesifik.