Tinni T. Maskoen
Departemen Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

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Red Cell Distribution Width to Albumin Ratio versus Red Cell Distribution Width to Platelet Ratio as Predictors of 28-Day Mortality in Sepsis Patients Admitted to the Intensive Care Unit Ningsih, Diana Fitria; Pison, Osmond Muftilov; Suwarman, Suwarman; Maskoen, Tinni T.; Oktaliansah, Ezra; Aditya, Ricky
Jurnal Anestesi Perioperatif Vol 13, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v13n3.4638

Abstract

Background: Sepsis is a leading cause of mortality in the Intensive Care Unit (ICU). Early identification of high-risk patients requires simple and accessible prognostic biomarkers. The Red Cell Distribution Width to Albumin Ratio (RAR) and Red Cell Distribution Width to Platelet Ratio (RPR) have been proposed as potential biomarkers.Methods: This prospective cohort study was conducted in the ICU of Dr. Hasan Sadikin General Hospital, Bandung, from July to September 2025, involving 71 subjects who met the Sepsis-3 criteria. RAR and RPR values were calculated from blood tests within the first 24 hours of ICU admission. The primary outcome was 28-day mortality. Statistical analysis used the Receiver Operating Characteristic (ROC) curve to determine the cut-off value, sensitivity, specificity, and Area Under the Curve (AUC). The AUC comparison between RAR and RPR was analyzed using the DeLong test.Results: A total of 41 patients (57.7%) experienced 28-day mortality. The optimal cut-off value for RAR was 5.7404 (Sensitivity 85.4%; Specificity 73.3%) with an AUC of 89.3% (95% CI: 79.8–95.4%). The optimal cut-off value for RPR was 0.0627 (Sensitivity 75.6%; Specificity 76.7%) with an AUC of 74.7% (95% CI: 63.0–84.3%). RAR had a significantly better discriminatory value than RPR (p=0.026).Discussion: The RAR value is a better predictor of 28-day mortality than the RPR value in septic patients treated in the ICU.Conclusion: RAR can be considered a simple and effective prognostic tool for the early risk stratification of septic patients.
Mortality Outcomes Associated with Blood Group O Versus Non-O in Patients Undergoing Coronary Artery Bypass Grafting Oktaliansah, Ezra; Maskoen, Tinni T.; Oey, Bernadeth; Suwarman, Suwarman; Pradian, Erwin; Zulfariansyah, Ardi
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4640

Abstract

Background: Coronary artery bypass grafting (CABG) carries an operative mortality of 1–7%. Von Willebrand factor (vWF) levels are approximately 30% lower in individuals with blood group O compared to non–O groups, potentially influencing post–CABG mortality. This study aimed to compare mortality between blood group O and non–O in adult patients after on–pump CABG in the ICU.Methods: A retrospective cohort study was conducted using secondary data from medical records of adult patients (>18 years) who underwent elective on–pump CABG in the ICU at Dr. Hasan Sadikin General Hospital, Bandung. A sample of 64 patients was required, with a 28–day follow–up post–CABG. Data were analyzed using unpaired t–tests, Mann–Whitney tests, Chi–square, and Fisher’s exact tests, with significance set at p<0.05, using SPSS version 26.0.Results: A total of 129 patients were included, comprising 64 patients with blood group O and 65 with non–O blood groups. Mortality in blood group O patients was 10.9% (7/64), compared with 29.2% (19/65) in non–O patients, a significant difference (p=0.010). Non–O blood group patients had nearly three times higher risk of mortality compared to those with blood group O.Discussion: The observed mortality differences are related to variations in vWF and factor VIII levels among blood groups. Lower vWF levels in blood group O may provide a protective effect against macro–thrombosis in coronary grafts, whereas higher factor VIII levels in non–O groups increase the risk of microvascular thrombosis and secondary myocardial ischemia after on–pump CABG.Conclusion: Adult patients undergoing on–pump CABG with non–O blood groups experience significantly higher mortality compared to those with blood group O. Blood group may be associated with postoperative mortality. However, its role as an independent prognostic factor requires further investigation.