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All Journal Sari Pediatri Paediatrica Indonesiana AcTion: Aceh Nutrition Journal Journal of Health and Nutrition Research
Edward, Eka Destianti
Unknown Affiliation
Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Risk factors of mortality in children with acquired prothrombin complex deficiency at Dr. Zainoel Abidin General Hospital,Banda Aceh Munawarah, Syifa; Sovira, Nora; Anidar, Anidar; Herdata, Heru Noviat; Edward, Eka Destianti; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.253-9

Abstract

Background  Acquired prothrombin complex deficiency (APCD) is a rare but life-threatening bleeding disorder in children. Intracranial hemorrhage (ICH) is the leading cause of death, with an estimated risk affecting 50–80% of cases. Key risk factors associated with mortality in APCD include onset of disease, presence of ICH, and the initial Glasgow Coma Scale (GCS) score. Routine intramuscular administration of vitamin K at birth has been shown to effectively prevent early and late-onset vitamin K deficiency bleeding. However, in settings where vitamin K prophylaxis is not administered or is delayed, the risk of APCD increases significantly. Despite these concerns, other potentially relevant clinical factors contributing to APCD outcomes remain under-investigated. Objective To identify risk factors associated with APCD mortality in children treated at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods This cross sectional study analyzing children diagnosed with APCD at Dr. Zainoel Abidin General Hospital from October 2022 to October 2024. Data were collected from the medical records of 30 children and analyzed using Chi-square and logistic regression tests. Results This study included 30 subjects, the majority of whom were male and aged 8 days to 6 months. Most of subject were born full term, delivered vaginally, and had birth weight ≥ 2.500 grams. Notably, 25/30 children did not receive vitamin K prophylaxis, 14/18 children were exclusively breastfed without vitamin K prophylaxis, and 25/30 children had good nutritional status. Late-onset APCD was observed in 14 out of 30 cases.  Intracranial vs extracranial hemorrhage was occurred in 21 vs 9 children. Initial GCS scores ≤ 8 at initiation of treatment were noted in 11/30 children. The mortality rate was occurred in 12/30 subjects (40%). Chi-square analysis revealed significant associations between increased mortality and late onset APCD (P=0.030), ICH (P=0.049), and initial GCS score ≤ 8 (P=0.009). Logistic regression analysis revealed initial GCS score was associated with the highest risk of mortality in APCD, with a 16-fold increase in risk (P=0.022; OR 15.9; 95%CI 1.5 to 168.9). Conclusion Intracranial hemorrhage, late-onset APCD, and initial GCS scores ≤ 8 are significantly associated with increased APCD mortality, with initial GCS emerging as the most influential risk factor.
Faktor Risiko Mortalitas Anak dengan Sepsis dan Disseminated Intravascular Coagulation: Peran Penanda Inflamasi dan Koagulasi di Rumah Sakit Zainoel Abidin Banda Aceh Nuriyanto, Alivia Rizky; Edward, Eka Destianti; Andid, Rusdi; Sovira, Nora; Herdata, Heru Noviat; Thaib, Teuku Muhammad
Sari Pediatri Vol 27, No 1 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.1.2025.9-17

Abstract

Latar belakang. Sepsis yang tidak tertangani dapat berlanjut menjadi Disseminated Intravascular Coagulation (DIC). Apabila DIC tidak segera ditangani dapat menimbulkan kegagalan organ dan meningkatkan mortalitas. Memahami pemeriksaan penanda inflamasi dan faktor koagulasi memegang peranan penting dalam prognosis dan upaya mencegah mortalitas pada anak dengan sepsis dan DIC. Tujuan. Untuk mengetahui faktor risiko mortalitas berdasarkan penanda inflamasi dan faktor koagulasi pada anak dengan sepsis disertai DIC di RSUD dr. Zainoel Abidin Banda Aceh.Metode. Penelitian ini merupakan studi observasional analitik dengan pendekatan cross-sectional pada anak usia 1 bulan sampai 18 tahun di ruang rawat inap dan Pediatric Intensive Care Unit (PICU) RSUD dr. Zainoel Abidin Banda Aceh sejak Januari sampai Desember 2023 dengan menggunakan data rekam medis 104 anak yang memenuhi kriteria penelitian. Analisa data Bivariat menggunakan uji chi-square dan uji fisher serta uji regresi logistik untuk data multivariat.Hasil. Insiden sepsis dan DIC pada anak sebanyak 104 subjek dengan kelompok meninggal paling banyak dijumpai pada kelompok usia <5 tahun, jenis kelamin perempuan, gangguan respirasi, ? 2 komorbid, lama rawatan yang lebih lama, skor PELOD-2 yang lebih dari 13, skor ISTH yang lebih dari 5, gizi baik dan penggunaan ventilasi mekanik. Faktor risiko mortalitas berdasarkan penanda inflamasi dan faktor koagulasi pada anak dengan sepsis dan DIC adalah Neutrofil to Lymphocyte Ratio (NLR) (p < 0,001) dengan OR 16,16 (IK95%: 4,43-154,42), leukosit (p=0,006) dengan OR 9,05 (IK95%: 1,83-43,79), D-dimer (p=0,006) dengan OR 6,25 (IK95%: 1,67-23,39) dan trombosit (p=0,026) OR 0,22 (IK95%: 0,06-0,835).Kesimpulan. Nilai NLR merupakan faktor risiko mortalitas pada anak dengan sepsis dan DIC.
Vitamin D and calcium status in children with thalassemia beta major: A cross sectional study in Banda Aceh Fiska, RR. Rima Aulia; Edward, Eka Destianti; Amna, Eka Yunita; Herdata, Heru Noviat; Sovira, Nora; Ismy, Jufitriani
AcTion: Aceh Nutrition Journal Vol 10, No 3 (2025): September
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i3.2486

Abstract

Frequent blood transfusions in children with beta-thalassemia major result in iron overload, leading to hemosiderosis in various body tissues, and impair the function of these organs, disrupting vitamin D metabolism, which contributes to osteoporosis and other morbidities, which are believed to be associated with hypocalcemia, which significantly affects growth. This study aimed to investigate the relationship between vitamin D and calcium status in children with β-thalassemia major at dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. Methods: An analytical observational study employed a cross-sectional design involving 40 children aged 2–18 years with a beta-thalassemia major attending the Children's Thalassemia Clinic at dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. from July to November, 2024. Categorical data were analyzed using the Spearman test, with a p-value of <0,05. Results, of the 40 subjects, 55% subjects were male, in 45% of subjects, there was Vitamin D deficiency, 25% was vitamin D insufficiency, hypocalcemia in 77,5% subjects. Among subjects with vitamin D deficiency, 94,4% also had hypocalcemia (r = 0,037, p = 0,017). In conclusion, there was a significant association between vitamin D and calcium status in children with beta-thalassemia major.
Nilai Rasio Neutrofil Limfosit dan Red Cell Distribution Width pada Neonatus Sepsis Machya, Farish; Darussalam, Dora; Herdata, Heru Noviat; Haris, Syafruddin; Edward, Eka Destianti; Dimiati, Herlina
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.146-51

Abstract

Latar belakang. Insiden sepsis pada negara berkembang sampai saat ini masih tinggi. Banyaknya faktor risiko yang memengaruhi, menjadikan sepsis sebagai penyumbang tingginya angka kematian pada bayi. Diagnosis yang seringkali terlambat ditegakkan karena pemeriksaan kultur darah sebagai Gold Standard baru bisa didapatkan hasilnya setelah beberapa hari. Deteksi dini sepsis neonatorum dapat diltegakkan salah satunya dengan pemeriksaan rasio neutrofil limfosit dan red cell distribution width.Tujuan. Menilai rasio neutrofil limfosit, red cell distribution width, dan faktor risiko pada neonatus dengan diagnosis sepsis di neonatal intensive care unit - NICU Rumah Sakit Zainoel Abidin Banda Aceh dengan luaran kematian.Metode. Penelitian desain kohort retrospektif dengan data rekam medis neonatus di NICU Rumah Sakit Umum Daerah Dr. Zainoel Abidin, Banda Aceh, dari Februari hingga Oktober 2023. Sebanyak 43 neonatus dengan diagnosis sepsis yang memenuhi kriteria inklusi dianalisis. Data yang dikumpulkan meliputi karakteristik demografis, hasil laboratorium, serta luaran klinis. Analisis dilakukan menggunakan uji Chi-square dan analisis multivariat dengan SPSS versi 20.0.Hasil. Diperoleh 88,3% neonatus menunjukkan peningkatan NLR, dan 86,05% mengalami peningkatan RDW. Terdapat hubungan signifikan antara metode persalinan sectio caesaria (p<0,03) dengan peningkatan risiko mortalitas. Neonatus dengan berat badan ?2500 gram dan usia gestasi preterm lebih sering mengalami peningkatan NLR dan RDW. Kesimpulan. Peningkatan nilai rasio neutrofil limfosit lebih banyak terjadi pada neonatus sepsis dibandingkan nilai red cell distribution width.
Correlation between Platelet Indices and PELOD-2 Score as Prognostic Markers in Pediatric Sepsis at Dr. Zainoel Abidin Hospital Pratiwi, Sari Novita; Sovira, Nora; Edward, Eka Destianti; Herdata, Heru Noviat; Safri, Mulya; Ismy, Jufitriani
Journal of Health and Nutrition Research Vol. 4 No. 3 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i3.613

Abstract

To determine the correlation between Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) with Pediatric Logistic Organ Dysfunction (PELOD-2) scores as prognostic markers in pediatric sepsis. This prospective cohort study included 44 pediatric sepsis patients admitted to the PICU at Dr. Zainoel Abidin Hospital from July to September 2024. PELOD-2 scores and blood indices were assessed on admission (Day 1) and Day 3. Pearson correlation was used to analyze the relationship between variables. The majority of patients were female (59.1%) and under one year old (31.8%). By Day 3, 68.2% of patients exhibited MPV levels exceeding 10.4 fL. Significant moderate correlations were found between Day 3 MPV and PELOD-2 (r=0.410; p=0.006), Day 3 PDW and PELOD-2 (r=0.518; p=0.001), and the changes ($\Delta$) in PDW versus PELOD-2 scores (r=0.471; p=0.005). Increases in MPV and PDW are significantly correlated with PELOD-2 scores, suggesting their potential utility as accessible prognostic markers in pediatric sepsis management.
Co-Authors Amna, Eka Yunita Anidar Anidar, Anidar Dora Darussalam, Dora Fiska, RR. Rima Aulia Herlina Dimiati, Herlina Heru Noviat Herdata, Heru Noviat Ismy, Jufitriani Machya, Farish Mulya Safri, Mulya Munawarah, Syifa Nora Sovira, Nora Nuriyanto, Alivia Rizky Pratiwi, Sari Novita Rusdi Andid, Rusdi Syafruddin Haris, Syafruddin Thaib, Teuku Muhammad