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Indra Saputra
Department Of Child Health, Medical School, Sriwijaya University, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia Destiana Sera Puspita Sari; Indra Saputra; Silvia Triratna; Mgs. Irsan Saleh
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.448 KB) | DOI: 10.14238/pi57.3.2017.164-70

Abstract

Background For critically ill patients in the pediatric intensive care unit (PICU), a scoring system is helpful for assessing the severity of morbidity and predicting the risk of mortality. The Pediatric Index of Mortality (PIM) 3 score consists of ten easy simple variables, so that the probability of death can be assessed prior to undergoing advanced therapies. The PIM 3 score in inexpensive and comprised of routine laboratory variables performed in PICU patients. In Indonesia, studies to validate the PIM 3 score have been limited.Objective To evaluate the PIM 3 score for predicting the probability of death in the PICU, Dr. Mohammad Hoesin Hospital (MHH), Palembang.Methods A prospective, cohort study was performed in the PICU, MHH, Palembang, from February to April 2016. The PIM 3 score was calculated within 2 hours of patients admission to the PICU by an  android calculator application. PIM3 score and mortality were analyzed by Mann-Whitney test; calibration was performed by Hosmer-Lameshow goodness of fit test, discrimination was done by receiver operating characteristic (ROC) curve analysis; and standardized mortality ratio (SMR) was calculated.Results During the study period there were 81 PICU patients, 69 children were included, ranging in age from 1,5 to 187 months. The overall mortality rate was 40,58%. The most common illnesses in our subjects were malignancy (17,4%), post non-thoracic surgery (14,5%), dengue shock syndrome (14,5%), respiratory disease (13%), and neurological disease (11,6%). Subjects’ PIM3 scores ranged from 1,02% to 58,84%, with means of 26,08% in non-survivors and 13,05% in survivors. The SMR was 2,24, indicating that death was underpredicted. The AUC of 0,771 (95% CI of 0,651 to 0,891) indicated that the PIM3 score had good discrimination.Conclusion In Mohammad Hoesin Hospital, Palembang, South Sumatera, the PIM 3 can be used to predict mortality in PICU patients, but the score should be multiplied by a factor of 2.24. This recalibration is needed due to the presumed lower standard of care at this hospital compared to that of the originating PIM 3 institutions in developed countries.
Pediatric SOFA score for detecting sepsis in children Muhammad Aulia; Silvia Triratna; Yulia Iriani; Achirul Bakri; Indra Saputra
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.1-7

Abstract

Background The pediatric logistic organ dysfunction-2 (PELOD-2) score is recommended by the Indonesian Pediatric Society Emergency and Intensive Care Working Group as an indicator of life-threatening organ dysfunction for sepsis in children. However, The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) recommended the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score in determining life-threatening organ dysfunction, which has not been adjusted for pediatric patients. Objective To assess the accuracy of the pediatric SOFA score in diagnosing sepsis in children admitted to the pediatric intensive care unit (PICU) at Mohammad Hoesin Hospital, Palembang, South Sumatera. Methods The study was conducted in children with organ dysfunction caused by infection admitted in PICU, from April to December 2019. Subjects were included by consecutive sampling, according to the following inclusion criteria: all patients aged 1 month to 18 years who met organ dysfunction and two SIRS criteria, with infection according to the 2005 PSCC criteria. Laboratory tests performed included complete blood count (CBC), blood gas analysis, measurement of C-reactive protein (CRP), liver and kidney function tests. In all patients, pSOFA and PELOD-2 scores were calculated within 24 hours of admission. We compared the accuracy of pSOFA score to PELOD-2 score >= 11. Results Of 108 subjects, there were 59 males and 49 females, with median age 11 (range 1-193) months. We compared the accuracy of pSOFA score to PELOD-2 score >= 11 and obtained a sensitivity of 93.3% and a specificity of 79.5%, for pSOFA cut-off score ? 8. Pediatric SOFA score cutoff >= 8 was determined by receiver operating curve (ROC). The area under the curve (AUC) for pediatric SOFA score was 93.9% (95%CI 89.7 to 98.0%). Conclusion Pediatric SOFA score >= 8 is the optimal cut-off for predicting life-threatening organ dysfunction in pediatric sepsis. Multicenter revalidation is needed to find the most optimal cut-off point for general use in Indonesia.
A COMMUNITY SEMINAR ON INTRODUCING THE EMERGENCY OF COVID-19 IN CHILDREN Indra Saputra; Silvia Triratna; Desti Handayani; Silmi Kaffah
Conferences of Medical Sciences Dies Natalis Vol. 3 No. 1 (2021): Conference of Medical Sciences Dies Natalis Faculty of Medicine Universitas Sri
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (634.222 KB)

Abstract

The Covid-19 virus infection has spread rapidly worldwide, making it the first pandemic of the 21st century to have caused many deaths (more than 2 million people died). Some shreds of evidence from a range of sources suggest that the rate of Covid-19 cases in children is relatively low, commonly have asymptomatic or mild symptoms, and have low mortality rates. Data released by the Indonesian Pediatrician Association (IDAI) regarding the mortality rate of children infected with Covid-19 is 42% are infants under one year of age. In addition, there are new reports of severe and life-threatening cases of Covid-19 complication in children, which occur 4-6 weeks after infection, known as Multisystem Inflammatory Disease in Children (MIS-C). In order to control the spreading of Covid-19 infection in children, many countries considered temporarily closing the school. However, in September 2021, the Ministry of Education and Culture of Indonesia decided to reopen the school. Schools that provide face-to-face learning for students are schools located in yellow zones or moderate-risk areas. In order to reopen the school safely, the children, teachers, and parents have to obey some strict safety protocols. Even though physically reopening schools might potentially increase the transmission in the community. Due to anticipate the increase in morbidity and mortality, it is very important to increase public knowledge about the signs and symptoms of COVID-19 in children.
Co-Authors Achirul Bakri Desti Handayani Destiana Sera Puspita Sari Mgs. Irsan Saleh Muhammad Aulia Silmi Kaffah Silvia Triratna Silvia Triratna Silvia Triratna Yulia Iriani