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All Journal Jurnal Kesehatan Andalas INDONESIAN JOURNAL OF PHARMACY Universa Medicina Media Ilmu Kesehatan Oto Rhino Laryngologica Indonesiana Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Poltekita : Jurnal Ilmu Kesehatan Health and Medical Journal Jurnal Dunia Gizi Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Scientific Journal Jurnal Ilmu Kesehatan Indonesia (JIKSI) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Jurnal Pengabdian Masyarakat Kesehatan (JURABDIKES) Jurnal Riset Ilmiah Neurona Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Eva Decroli
Endocrinology And Metabolic Subdivision, Division Of Internal Medicine, Dr. M. Djamil General Hospital/ Medical Faculty Of Andalas University, Padang, West Sumatera, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Journal : Universa Medicina

 1 
In-hospital mortality and its determinant factors among patients with sepsis Fadrian, Fadrian; Decroli, Eva; Ahmad, Armen; Kam, Alexander; Muharramah, Disa Hijratul; Pradana, Genta; Putri, Vidola Yasena
Universa Medicina Vol. 44 No. 1 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.3-15

Abstract

BACKGROUNDSepsis is a heterogeneous syndrome characterized by a variety of clinical features. Multiple studies have identified sepsis as the leading cause of death in hospitalized patients. A comprehensive report on the incidence, clinical characteristics, and predictors of sepsis is important. This study aimed to determine the relative importance of predictors of in-hospital mortality in sepsis. METHODSA retrospective cohort study at Dr. M. Djamil Central General Hospital focused on sepsis patients. A total of 200 participants, aged 18 and older, were included based on specific criteria and recruited through consecutive sampling. Data was gathered from medical records and laboratory results to identify factors influencing mortality in sepsis patients. These factors were classified into sociodemographic, intrinsic, and extrinsic categories. Statistical analysis utilized simple and multiple logistic regression. A p-value of less than 0.05 indicated statistical significance for predicting in-hospital mortality in sepsis. RESULTSThe sepsis patient mortality rate was 69.50%. Hospital-acquired pneumonia (HAP) emerged as the most common infectious diagnosis, impacting 47.50% of the patients. Type 2 diabetes mellitus (Type 2 DM) was identified as the most frequent comorbidity, present in 36.50% of cases. Multivariate analysis indicated that HAP (adjusted odds ratio [aOR] 2.32; 95% confidence interval [CI] 1.19–4.49; p=0.013) and hyperlactatemia (aOR 2.11; 95% CI 1.06–4.18; p=0.032) significantly increased the risk of mortality in sepsis patients. CONCLUSIONHospital-acquired pneumonia was the primary predictor of mortality in sepsis patients. Timely prediction and evaluation of sepsis outcomes are essential for developing strategies to reduce mortality rates.
Glucocorticoid-induced adrenal insufficiency after receiving intravenous methylprednisolone for Graves' ophthalmopathy: a case report Pradwi Efendi, Yanne; Aprilia, Dinda; Decroli, Eva
Universa Medicina Vol. 45 No. 1 (2026): Aheaf Of Print
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2026.v45.%p

Abstract

BACKGROUNDGraves’ ophthalmopathy (GO) is the most common extrathyroidal manifestation of Graves’ disease and can significantly impair visual function and quality of life. High-dose intravenous methylprednisolone (IVMP) is recommended as first-line therapy for moderate-to-severe active GO due to its superior efficacy and tolerability compared with oral glucocorticoids. However, IVMP therapy may be associated with rare but potentially serious adverse effects, including suppression of the hypothalamic–pituitary–adrenal (HPA) axis leading to GI adrenal insufficiency (GI-AI). Case descriptionWe report the case of a 38-year-old man with Graves’ disease who developed AI following IVMP therapy for moderate-to-severe GO. The patient received five weekly doses of IVMP 500 mg (cumulative dose 2.5 g) for progressive ocular symptoms. He subsequently presented with fatigue, weight gain, moon face, and buffalo hump. Laboratory evaluation revealed a markedly low morning serum cortisol level of 1 mcg/dL, confirming adrenal insufficiency. Patient was diagnosed with GI-AI accompanied by features of iatrogenic Cushing’s syndrome. Management consisted of hydrocortisone replacement therapy at a dose of 20 mg/day along with ongoing antithyroid treatment using methimazole. Serial monitoring of cortisol levels demonstrated gradual recovery of HPA axis function, accompanied by clinical improvement. ConclusionThis case highlights that glucocorticoid-induced adrenal insufficiency can occur on IVMP used for GO. Clinicians should maintain a high index of suspicion and perform appropriate adrenal function monitoring during and after IVMP therapy to ensure early detection and safe management of this potentially life-threatening complication.
Co-Authors Adang Bachtiar Ade Chandra Afriwardi Afriwardi Ahmad, Armen Al Hafiz Alexander Kam Alexander Kam Alexander Kam Alexander Kam Alfitri, Maura Salsabila Andi Fadilah Yusran Putri Antoni, Adi Aprilia, Dinda Asman Manaf Aulia, Salsabila Syafna Auliangi Tamayo Brian Sri Prahastuti Darwin Amir, Darwin Deddy Saputra Delmi Sulastri Dessy Arisanty Dinda Aprilia Dinda Aprilia Dinda Aprilia Dinda Aprilia Dwitya Elvira, Dwitya Efendi, Nursyirwan Efendi, Yanne Pradwi Ellyza Nasrul Eryati Darwin Eti Yerizel Fadella, Annesa Fadrian, Fadrian Fahrurozi, R. Ifan A. Fauzar Fauzar Fereshti Lailani Finisia Noviyanti Firdawati Firdawati Garri Prima Decroli Genta Pradana, Genta Hafni Bachtiar Hardisman Harie Satria ES Husna Yetti Jannah, Lidya Raudhatul Jonggara Oktaviandra Siahaan Kam, Alexander Linosefa Linosefa Martini, Rose D Meliza Wahyuni Mudjiran Muhammad Luthfi Muharramah, Disa Hijratul Murni, Arina W Mustafa Noer Muthia Faurin Nada Utami Prahastiwi Nadila Andam Astari Namanda Putri, Athari Fadhila Nining Kurniawati Nur Indrawati Lipoeto Nurhayati Nurhayati Pradwi Efendi, Yanne Prayitno, Irwan Putri Deas Hadilofyani Putri Sri Lasmini Putri, Biomechy Oktomalio Putri, Septia Harma Putri, Vidola Yasena Rahayuningsih, Sri Puji Restu Susanti Risviani, Darayani Ritonga, Sukhri Herianto Robby Satria Putra Roza Kurniati Roza Mulyana Saptino Miro Saptino Miro, Saptino Sheila Jihan Safira Sofiani, Dinda Putri Suci Berlian Hemilton Sukri Rahman Susila Sastri Syafril Syahbuddin Syafril Syahbuddin Syafril Syahbuddin Tamayo, Auliangi Try Rahmi Lussii Karsuita Ulvyana, Vyora Viotra, Deka Yanne Pradwi Efendi Yanne Pradwi Efendi Yoga, Vesri Yulia, Dwi Yuliarni Syafrita Yusrawati Yusrawati Yustini Alioes Zelly Dia Rofinda