Garuda - Garba Rujukan Digital

Risk Factors Analysis for Rapid In-Hospital Mortality among Covid-19 Patients in a Tertiary Care Hospital in Indonesia Febriawati, Juwita; Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Djajalaksana, Susanthy
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.15

Systemic inflammation plays an important role in pathogenesis of Covid-19, especially in development of ARDS which is characterized by decrease of PaO2/FiO2 ratio. CRP and procalcitonin are inflammatory markers that are closely associated with severity and mortality of Covid-19. Although several studies have addressed benefit of CRP and procalcitonin as markers on Covid-19 severity, the benefit of these inflammatory markers for in-hospital mortality remain inadequately understood. The aim of this study was to analyze PaO2/FiO2 ratio,comorbidity,CRP,and procalcitonin as risk factors that affect time of in-hospital mortality Covid-19 patient. This was a retrospective observational cohort study of 250 Covid-19 patients who died during hospitalization and data was retrieved from medical record. Laboratory data was collected from three different times, including at time of admission,third day of hospital care,and before patient’s death. Data were analyzed using Chi square test,Mann Whitney test,Wilcoxon test, Friedman test, and binary logistic regresion. There were significant differences between CRP and procalcitonin at admission and time of in-hospital mortality (p<0.001; p=0.007). Binary logistic regression analysis revealed significant relationship between CRP and time of in-hospital mortality with p=0.007. ROC curve showed optimal threshold of 11.75mg/L with sensitivity 72.3%; specificity 59.6%, RR 3.24(95% CI: 1.84-5.70). Significant changes were observed regarding PaO2/FiO2 ratio,CRP,and procalcitonin at admission as compared to before patient’s death with p<0.001;p=0.017;p<0.001 respectively. This study showed significant decrease of PaO2/FiO2 ratio, elevated CRP and procalcitonin at admission as compared to before patient’s death. The increase of CRP could serve as predictor for time of in-hospital mortality for Covid-19 patient.

The Effects of N-Acetylcysteine as Adjuvant Therapy To Reduce TNF-Î‘ Level And Increase SPO2/FIO2 Ratio In Improving Hypoxemia In COVID-19 Patients Ramadhan, Fitratul; Putra, Ngakan Putu Parsama; Setyawan, Ungky Agus; Djajalaksana, Susanthy; Listyoko, Aditya Sri; Al Rasyid, Harun
Indonesian Journal of Tropical and Infectious Disease Vol. 9 No. 3 (2021)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v9i3.30874

Tumor Necrosis Factor Alpha (TNF-α) is a pro-inflammatory cytokine that plays a crucial role in COVID-19 disease progression. N-acetylcysteine (NAC) works throughout several GSH-mediated mechanisms and is known to eliminate oxidative stress in acute respiratory distress syndrome (ARDS) in COVID-19. This study aims to analyze the effect of the N-Acetylcysteine as Adjuvant Therapy to reduce TNF-α levels and Increase SpO2/FiO2 ratio in Improving hypoxemia in COVID-19 Patients. This is a quasi-experimental, non-equivalent control group design study. There were 91 subjects selected using non-random sampling, which consisted of 75 patients in the NAC group and 16 patients in the control group. The TNF-α level was measured using the ELISA method, and SpO2/FiO2 ratio was calculated on day 1 (on admission) and day eight after NAC 5000mg/ 72 hours was given. Statistical analysis was conducted using Wilcoxon and Mann-Whitney U Test. There is a significant decrease in TNF-α level in the treatment group (median 1.49±5.22) (p=0.016) compared with the control group (median 1.64±1.99) (p=0.005). The Median SpO2/FiO2 ratio on day 1 is 163.70±69.64 in the control group and 121.49±40.41 in the treatment group (p=0.005). The Median SpO2/FiO2 ratio on day 8 is 249.69±132.26 in the control group and 151.29±59.18 in the treatment group (p=0.001). There is a positive correlation between serum TNF-α level and SpO2/FiO2 ratio after administration of adjuvant therapy NAC (r=0.240, p=0.038). There is a positive correlation and significant decrease of serum TNF-α and SpO2/FiO2 ratio after adjuvant NAC therapy, which improves hypoxemia in COVID-19 patients.

Hubungan Merokok Dengan Derajat Keparahan Dan Mortalitas Pasien COVID-19 Rawat Inap di RS Saiful Anwar Malang Listyoko, Aditya Sri; Djajalaksana, Susanthy; Astuti, Triwahju
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang: Sejak Desember 2019 ketika pertama kali kasus COVID-19 diidentifikasi di Wuhan, China, SARS-CovV-2 menyebar ke seluruh dunia dan memberikan angka penyebaran infeksi dan mortalitas yang terus meningkat. Merokok memberikan dampak negatif terhadap kesehatan paru. Merokok sampai saat ini diasumsikan merupakan faktor risiko berbagai penyakit paru dan pernapasan seperti PPOK, kanker paru, termasuk pengaruh terhadap sistem pertahanan jalan napas terhadap berbagai mikroorganisme patogen. Prevalensi merokok di Indonesia sangat tinggi, dimana masih sedikit sekali studi yang dilakukan di Indonesia khususnya menilai risiko riwayat merokok terhadap derajat keparahan dan mortalitas pada pasien COVID-19 yang dilakukan rawat inap. Tujuan: Menganalisis riwayat merokok pada pasien COVID-19 yang dirawat di RS rujukan utama dan hubungannya dengan derajat keparahan penyakit dan mortalitas. Metode: Kami melakukan analisis observasional dengan pendekatan cross sectional, single-center, pada 77 pasien terkonfirmasi COVID-19. Data diambil antara bulan April-Juli 2020 pasien yang dirawat di Ruang COVID RS Dr. Saiful Anwar Malang, Indonesia. Uji statistik dipergunakan untuk menilai hubungan riwayat merokok dengan derajat keparahan dan mortalitas. Hasil: Subjek terdiri 77 pasien terkonfirmasi COVID-19 terbagi 2 kelompok yaitu 31 (40,25%) pasien ringan-sedang dan 46 (59,74%) pasien kelompok berat. Subjek dikelompokkan menjadi luaran hidup 52 (68,42%) dan meninggal 24 (31,57%) untuk analisis mortalitas. Analisis statistik menunjukkan riwayat merokok berkaitan dengan derajat keparahan penyakit (p=0,008; OR: 4,75, 95%CI 1,426-15,817) dan mortalitas (p=0,045, OR: 2,821, 95%CI 1,007-7,900) pasien COVID-19 yang dilakukan rawat inap di rumah sakit. Kesimpulan: Merokok berkaitan dengan risiko COVID berkembang ke derajat berat serta mortalitas pada pasien COVID-19 yang dilakukan rawat inap. Kata kunci: COVID-19, Keparahan, Mortalitas, Merokok Background: Since December 2019, when the COVID-19 case was first identified in Wuhan, China, SARS-CoV-2 has spread worldwide and increased the incidence and mortality. To date, smoking is assumed to be a risk factor for various respiratory diseases such as COPD, lung cancer, also influences the airway defense system against various pathogenic microorganisms. The prevalence of smoking in Indonesia is very high where very few studies have been conducted in Indonesia especially assessing the risk of smoking and disease severity and mortality in hospitalized COVID-19 patients. Objective : To determine the risk of smoking history among hospitalized COVID-19 patients in tertiary care referral hospital and its association with disease severity and mortality. Methods: A cross-sectional single-center study was performed of 77 admitted laboratory-confirmed patients in a tertiary hospital in Malang City, East Java, Indonesia from April-July 2020. Statistical analysis was performed to evaluate the association between smoking and disease severity and mortality in COVID-19 patients. Results: A total of 77 patients with laboratory-confirmed COVID-19 were included in our analysis. Subjects divided in the mild-moderate and severe group 31 patients (40,25%) and 46 patients (59,74%) respectively. For mortality analysis, subjects divided into survivor 52 patients (68,42%) and non-survivor 24 patients (31,57%). Statistical analysis determine smoking associated with disease severity (p=0,008; OR : 4,75, 95%CI 1,426-15,817) and mortality (p=0.045, OR : 2,821, 95%CI 1,007-7,900) in hospitalized COVID-19 patients. Conclusion: In our cross-sectional study demonstrated history of smoking associated with disease severity and mortality in hospitalized COVID-19 patients. Keywords: COVID-19, Mortality, Severity, Smoking

COVID-19 :Correlation Between CRP and LDH to Disease Severity and Mortality In Hospitalized COVID-19 Patients Tjahyadi, Rizal Muldani; Astuti, Triwahju; Listyoko, Aditya Sri
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Background and Objective:COVID–19 is a newly emerging disease and considered an emergency health problem, worldwide.It has a wide range of clinical features, from mild fever to severe respiratory failure that leads to a higher mortality rate. Previous studies state that CRPhas a very strong positive correlation with the diameter of the lung lesion, and in intensive care patients had a higher level of LDH. This study aims to determine the correlation between CRP, LDH and disease severity and mortality in hospitalized COVID-19 patients. Methods: We conducted a retrospective cohort, a single-center study including 69 laboratory-confirmed patients in our hospital in Malang City, Indonesia from April - June 2020. Result: Subjects consisted of 26 patients (37.7%) in the mild-moderate group and 43 patients in severe group (62.3%).Statistical analysis showed CRP and LDH associated with disease severity (p=0.011 and p<0.001). Analysis of CRPand LDH in survivor and non-survivior group showed that CRP and LDH also asscociated with mortality in hospitalized COVID-19 patients (p=0.034 and 0.002). We also evaluate CRP and LDH with degrees of hypoxemia by assessed P/F ratio. Statistical analysis showed that CRP did not correlate with degrees of hypoxemia (p=0.079) but LDH inverse correlate with degrees of hypoxemia (p<0.001, pearson correlation = -0,489) Conclusion: In our retrospective cohort study demonstrated LDH and CRP can be a crucial indicator to predict severity and mortality for hospitalized COVID-19 patients and LDH may usefull test for predict early identification of patients who become respiratory failure or ARDS. Keywords: COVID-19, LDH, CRP, P/F Ratio

Analisis Faktor Koagulasi : Korelasi Fibrinogen dengan Rendahnya Derajat Oksigenasi Pada Pasien COVID-19: Faktor Koagulasi Pada COVID-19 Listyoko, Aditya Sri; Djajalaksana, Susanthy; Sugiri, Yani Jane
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Background: Hipercoagulable state is a one complication of COVID-19. The exact mechanism are still unclear, however hyperfibrinogenemia is considered one of the mechanisms for COVID-19 coagulopathy. Objective : To analyze the parameters of coagulation factors of COVID-19 patients and its correlation with degree of oxygenation Methods: We conducted an observational analytic, cross sectional, single-center study including 25 laboratory-confirmed patients in Dr. Saiful Anwar General Hospital, Malang, Indonesia from April-Juni 2020. Statistical analysis performed to determine coagulation factors like fibrinogen, D-dimer, thrombocyte and its relationship to disease severity and correlation with degree of oxygenation measured by PaO2/FiO2. Result: Subjects consisted of 12 patients (48%) in the mild-moderate group and 13 patients (52%) in severe group. D-dimer with mean 1,30 mg/L (0,43 mg/L - 4,08 mg/L) increased in 11 patients (91,67%) in mild-moderate group and 11 patients (84,61%) in severe group with mean 11,42 mg/L (0,34 mg/L – 66,30 mg/L). Fibrinogen with mean 399,73 mg/dL (235,10 mg/dL -529 mg/dL) increased in 7 patients (58,33%) in mild-moderate and 10 patients (76,92%) in severe group with mean 444,31 mg/dL (284,7 mg/dL – 543,0 mg/dL). Statistical analysis revelaed that D-dimer associated with disease severity (p=0,039) and fibrinogen was inversely correlated with degree of oxygenation measured by PaO2/FiO2 ratio with moderate correlation strength (p = 0.019; Pearson correlation = -4,67). Conclusion: High level of fibrinogen correlated with decrease of oxygenation and D-dimer associated with disease severity in hospitalized patients, suggested increasing coagulable factors such as fibrinogen and D-dimer may be the main keys developing severe condition in COVID-19 patients.

Comparison of ROX Index and Surfactant Protein-D with HFNC Outcome in COVID-19 Patients Rozi, Achmad Syamsufandi; Parsama Putra , Ngakan Putu; Setyawan, Ungky Agus; Listyoko, Aditya Sri
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.924

Background: In COVID-19, severe clinical deterioration can lead to respiratory distress. High Flow Nasal Cannula (HFNC) is an oxygenation treatment recommended in severe COVID-19 patients, with various studies showing decreased recovery time and intensive care needed. However, instruments to predict HNFC outcomes, specifically in COVID-19, are not yet widely studied. ROX index is a practical instrument proven effective in predicting HFNC outcome in pneumonia while showing high variabilities of optimum time of assessments and cut-off values in COVID-19. Surfactant Protein-D (SP-D) is an alveolar protein showing potential as a biomarker in acute lung injury and respiratory distress. In this study, we analyzed ROX index and SP-D potential as HFNC outcome predictors in COVID-19 patients. Methods: This prospective study recruited severe and critical COVID-19 patients treated with HFNC. Patient characteristics, laboratory values including initial serum SP-D values, and ROX index were recorded. Significant differences were analyzed using Chi-Square and Mann-Whitney tests. Receiver operating characteristic (ROC) analysis was used to determine HFNC outcome predictive abilities of ROX index and serum SP-D. Result: 31 subjects with successful HFNC outcomes in 19 subjects and failed HFNC outcomes in 12 subjects were included in this study. ROX index and SP-D value were significantly higher in subjects with successful HFNC compared to failed HFNC (p < 0.05). ROX index at 6, 12, and 24 hours showed good HFNC outcome predictive ability (AUC > 0.7, p < 0.05). Conclusion: Successful HFNC outcome in COVID-19 was significantly related to higher ROX index and serum SP-D values. ROX index also showed good potential as an HFNC outcome predictor in COVID-19 patients.

The Correlation between Volatile Organic Compounds (VOC) with Leukotriene B4 and Eosinophil Counts in Chronic Obstructive Pulmonary Disease Patients Santosa, Andrew; Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Wardoyo, Arinto Yudi Ponco; Setijowati, Nanik
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1035

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by increasing Leukotriene B4 (LTB4) and eosinophil counts. Volatile organic compounds (VOCs) have shown promise as non-invasive biomarkers, reflecting COPD pathophysiology. Identifying specific VOCs associated with increased LTB4 and eosinophil counts could lead to the discovery of potential biomarkers for COPD severity or progression. AIMS: This study aims to investigate the correlation between VOCs and leukotriene B4 (LTB4) levels, as well as eosinophil counts counts in COPD patients. METHOD: Using an observational-analytic method with a case-control approach, 20 COPD patients and 20 controls were enrolled from the respiratory outpatient department of Dr. Saiful Anwar General Hospital, Malang. VOC levels were measured using a breath analyzer, while LTB4 levels were determined through enzyme-linked immunosorbent assays. Spearman’s correlation tests examined associations between VOCs, LTB4, eosinophil counts, and comorbidity, with Mann-Whitney tests comparing results against the control group. Data significance was set at p < 0.05. RESULT: There were 40 COPD patients and 40 controls in this study. There were significant differences between VOCs in the COPD group and the control group (p < 0.05). LTB4 level significantly increased in the COPD group than in the control group (p < 0.001), and there was no difference in the eosinophil level. There was a correlation between LTB4 and VOC level of C2H5OH in COPD patients (p = 0.009; r = 0.410). There was no correlation between eosinophil counts and VOCs (p = 0.939). The level of VOCs was significantly different between patients with only COPD and patients with COPD and comorbid lung cancer (p < 0.05). CONCLUSION: There is a correlation between VOC and LTB4 in COPD patients.

Volatile Organic Compounds (VOC) and Serum Leukotriene B4 between COPD Patients and COPD with Lung Cancer Patients Djajalaksana, Susanthy; Listyoko, Aditya Sri; Prasetyo, Kevin Wahyudy; Wardoyo, Arinto Yudi Ponco
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.222-227

Introduction: Chronic obstructive pulmonary disease (COPD) is estimated to become the third leading cause of death worldwide in 2030. COPD can affect the lungs and cause chronic systemic inflammation. Leukotriene B4 (LTB4) is involved in COPD and lung cancer pathogenesis. There has been the development of non-invasive methods for detecting lung disease in the last few decades, such as the examination of volatile organic compounds (VOC). This study aimed to analyze the serum LTB4 and the difference of VOCs in exhaled breath of stable COPD patients and COPD with lung cancer patients. Methods: This case-control study recruited 20 stable COPD patients and 20 patients with COPD and lung cancer. An exhaled breath sample was collected in Tedlar bags and analyzed using an arrayed sensor breath analyzer to check the concentration of VOCs. Meanwhile, a venous blood sample was collected to examine the level of LTB4 using an ELISA kit. Independent t-test and Mann-Whitney test were used to analyze the data. Results: The carbon dioxide (CO2), nitrogen dioxide (NO2), carbon monoxide (CO), benzene (C6H6), and propane (C3H8) levels were significantly different (p <0.05) in COPD-only patients compared to COPD with lung cancer patients. Serum LTB4 increased in both groups. Conclusion: CO2, CO, and C3H8 levels increased, but the NO2 level decreased in COPD patients with lung cancer compared to COPD-only patients. Serum LTB4 increased in COPD with lung cancer patients.

ANALISIS GENDER TERHADAP VITAL SIGN, BORG SCALE, DAN KADAR KARBON MONOKSIDA PADA PENGGUNAAN MASKER UNTUK SENAM PERNAPASAN DI ERA PANDEMI COVID-19 Triandani, Ni Komang Revina; Listyoko, Aditya Sri; Ratnaningrum, Safrina Dewi; Widodo, Edwin; Djajalaksana, Susanthy
Majalah Kesehatan Vol. 12 No. 1 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Senam pernapasan merupakan olah napas yang bermanfaat untuk meningkatkan kesehatan dengan mengefektifkan semua organ dalam tubuh secara optimal. Pada era pandemi COVID-19 penggunaan masker telah menjadi kebiasaan baru termasuk pada saat berolahraga. Salah satu faktor yang mempengaruhi penggunaan masker yaitu perbedaan gender dimana laki-laki dan perempuan memiliki kapasitas volume paru-paru yang berbeda. Penelitian ini bertujuan untuk mengetahui pengaruh perbedaan gender dan penggunaan masker terhadap tanda-tanda vital, Borg scale dan kadar CO peserta senam pernapasan di RSUD Dr. Saiful Anwar Malang. Pengamatan dilakukan pada 3 (tiga) sesi yaitu sebelum senam, tahap inti, aerobic, dan setelah tahap pendinginan. Penelitian menggunakan data sekunder dengan pendekatan metode analitik case control, kemudian dilakukan uji independent t test dan Mann Whitney. Hasil analisis tanda-tanda vital pada setiap sesi menunjukkan bahwa tidak terdapat perbedaan heart rate, respiratory rate, dan kadar CO yang signifikan antara kelompok yang bermasker dan tidak bermasker pada gender yang berbeda (p > 0,05). Sedangkan terdapat perbedaan saturasi oksigen yang nyata (p < 0,05) antara kedua kelompok tersebut pada tahap inti, aerobik, dan setelah pendinginan. Hasil analisis Borg scale menunjukkan berbeda (p < 0,05) pada tahap inti dan aerobik. Penelitian ini menunjukkan bahwa tidak ada perbedaan bermakna penggunaan masker pada senam pernapasan pada gender laki laki maupun perempuan untuk kelompok dewasa muda sehat sehingga penggunaan masker bedah mungkin dapat di pakai ketika melakukan senam pernapasan dalam era pandemi COVID-19.

Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer Santoso, Agus Andreas; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane; Al Rasyid, Harun; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.140-146

Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.

Title

Found 14 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 14 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 14 Documents
Search