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Bustami, Mursyid
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Skor ICH-GS untuk Prediksi Prognosis Pasien Stroke Perdarahan Intraserebral di Rumah Sakit Islam Jakarta Pondok Kopi Pandhita S, Gea; -, Samino; Bustami, Mursyid
Cermin Dunia Kedokteran Vol 44, No 12 (2017): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1113.965 KB) | DOI: 10.55175/cdk.v44i12.686

Abstract

Latar Belakang dan Tujuan. Prediksi prognosis yang akurat pada kasus stroke perdarahan intraserebral (PIS) sangat penting untuk menentukan pilihan terapi. Penelitian ini bertujuan menguji manfaat klinis skor ICH-GS untuk memprediksi prognosis pasien stroke PIS selama rawat inap di Rumah Sakit Islam Jakarta Pondok Kopi (RSIJPK). Metode. Seluruh pasien rawat inap yang tercatat di bagian rekam medis RSIJPK dengan diagnosis stroke PIS pada periode Januari-Desember 2013 diikutkan dalam penelitian ini. Diagnosis stroke PIS ditegakkan berdasarkan gambaran klinis defisit neurologis mendadak dan memiliki gambaran perdarahan intraserebral berdasarkan pemeriksaan CT scan kepala. Skor ICH-GS diukur pada semua subjek penelitian saat di Instalasi Gawat Darurat (IGD). Skor tersebut kemudian dievaluasi untuk memprediksi angka mortalitas pasien stroke PIS selama rawat inap di rumah sakit. Hasil. Terdapat 47 pasien stroke PIS yang dianalisis dalam penelitian ini. Kisaran skor ICH-GS yang didapatkan adalah 5-12. Angka mortalitas keseluruhan selama rawat inap adalah 34%. Makin tinggi skor ICH-GS, makin tinggi mortalitasnya. Mortalitas pasien stroke PIS dengan skor ICH-GS 7-9 lebih rendah pada kelompok pasien yang mendapat terapi operatif dibandingkan kelompok pasien yang mendapatkan terapi non-operatif. Sebaliknya, mortalitas pasien stroke PIS dengan skor ICH-GS 10-11 lebih tinggi pada kelompok operatif dibandingkan kelompok non-operatif. Pasien stroke PIS dengan skor ICH-GS 6 pada kedua kelompok memiliki mortalitas yang sama. Simpulan. Skor ICH-GS dapat digunakan untuk memprediksi prognosis sehingga diharapkan dapat membantu tenaga medis dalam menentukan pilihan strategi terapi operatif atau non-operatif.Background. Accurate prediction of outcome after primary ICH is necessary to distinguish patients who will benefit from particular therapeutic strategies. The aim of the present study was to test the clinical usefulness of the ICH-GS score in predicting the prognosis of ICH patients in PK-JIH. Methods. Patients diagnosed with ICH between January to December 2013 were screened and enrolled in this study. ICH-GS score was evaluated to predict in-hospital mortality. Results. A total of 47 patients were included in the final analysis. Craniotomy was performed in 26% patients (surgery group). In-hospital mortality rates for patients with ICH-GS scores of 5 to 12 were 0%, 0%, 20%, 29%, 33%, 40%, 86%, and 100%, respectively. In the adjusted analysis, in-hospital mortality rates for patients with ICH-GS scores of 7-9 were lower in surgery group (p<0,05). Among patients with ICH-GS scores of 10-11 in-hospital mortality rates were higher in surgery group (p<0,05). In-hospital mortality rates for patients with ICH-GS scores of 6 in surgery group were equal to patients in non-surgery group. Conclusion. ICH-GS is a simple scale for predicting in-hospital mortality. ICH-GS can give a simple overview to distinguish patients who would benefit from specific therapeutic strategies.
Improving hospital formulary drug decision making with multi-criteria decision analysis (MCDA): case study from a national government hospital in Indonesia Kristin, Erna; Bustami, Mursyid; Pinzon, Rizaldy Taslim; Alfi Yasmina; Susanto, Agnes; Febrinasari, Ratih Puspita
Indonesian Journal of Pharmacology and Therapy Vol 4 No 3 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7932

Abstract

This study aimed to look at the applicability of the multi-criteria decision analysis (MCDA) framework to improve hospital formulary drug decision-making. The case study method was used to investigate MCDA implementation in the National Brain Center Hospital Jakarta, Indonesia. A two stage-workshop was held on October 29th, 2019 and 5 February 5th, 2020, where participants conducted a hands-on experience in applying MCDA for selecting off-patent pharmaceuticals (OPPs) for the hospital formulary. The results of the workshop created awareness of MCDA that can be beneficial in transparently selecting OPP, which is not based only on price while involving multiple stakeholders. As a follow-up, MCDA was used during the drug selection process for the National Brain Center Hospital formulary in 2021 with criteria in accordance with the workshops, namely: 1) equivalence with the reference (originator) product; 2) real-world clinical or economic outcomes; 3) quality assurance; 4) reliability of drug supply; 5) stability and drug formulation; 6) pharmacovigilance, and 7) price advantages. In conclusion, the MCDA method can be implemented with customized criteria and weighting based on hospital needs to help with drug selection for the hospital formularies.
Co-Authors Alfi Yasmina Erna Kristin Pandhita S, Gea Ratih Puspita Febrinasari Rizaldy Pinzon Samino -, Samino Susanto, Agnes