Article Per Year (5 Year)
p-Index From 2020 - 2025
1.407
P-Index
This Author published in this journals
All Journal Medicina E-Jurnal Medika Udayana JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Cermin Dunia Kedokteran Cermin Dunia Kedokteran
I Ketut Wiargitha
Department Of Surgery, Medical Faculty Udayana University – Sanglah General Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 18 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 18 Documents
Search

 1   2 
Diagnostic validity of PULP (peptic ulcer perforation) score in predicting mortality in patient with operated perforated peptic ulcer in Sanglah Hospital- Denpasar Inge Kurniawati; I Ketut Wiargitha; Tjokorda Gde Bagus Mahadewa; Bianca Jeanne
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (379.326 KB)

Abstract

Background: Perforated peptic ulcer (PPU) is one of the most common non-traumatic emergency cases in the emergency unit, and have a high mortality rate, more than 70% in the elderly. Accurate and early identification of high-risk surgical patients with PPU is important for triage and risk stratification. The objective of this study was to evaluate the mortality in patients with operated PPU. Methods: Between January 2015 to December 2016, 50 consecutive patients with PPU who performed laparotomy were studied retrospectively. This study was a diagnostic test to evaluate the validity of PULP (Peptic Ulcer Perforation) score to predict mortality in patient with operated PPU and determine the best cut-off point. Presentation ≥ or < 24 hours, age of 65 years old, the presence of preoperative shock, ASA score, the presence of AIDS or active malignancy, liver failure, concomitant use of steroids and serum creatinine > 14.7 g/dL were evaluated in PULP score. Results: The cut-off point for PULP the score in the present study is > 7, based on the optimal cut-off value, patients could be divided into low-risk patients (a score of < 7 points), and high-risk patients (a score of > 7 points). PULP score had 91.7% sensitivity, 65.4% specificity, and 78% accuracy in this study. Positive predictive value and negative predictive the values were 71% and 89.9%. Conclusion: The PULP score is sensitive to predict the mortality risk in patients operated for perforated peptic ulcer and can assist in risk stratification and triage.
Diagnostic validity of blunt abdominal trauma scoring system (BATSS) on blunt adominal trauma in Sanglah General Hospital, Denpasar, Bali Adityas Sukmadi Karjosukarso; I Ketut Wiargitha; Tjokorda Gde Bagus Mahadewa; Nova Juwita
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (332.693 KB)

Abstract

Background: Abdominal trauma is the third leading cause of death in trauma patients and can be found in about 7-10% of the total number of trauma cases. The Blunt Abdominal Trauma Scoring System (BATSS) provides a high-accuracy score system for diagnosing injury to intra-abdominal organs in blunt abdominal trauma patients based on clinical features, such as patient history, physical examination, and Focused Assesment with Sonography for Trauma (FAST). This studyaimed to determine the validity of the diagnostic value of BATSS score in cases of blunt abdominal trauma. Method: This research was conducted at Sanglah General Hospital, Denpasar with a total sample of 44 patients. The subjects were abdominal blunt trauma patients who meet the inclusion and exclusion criteria. This study was a retrospective study to determined the validity of the BATSS score. Result: Of the 44 patients, BATSS score ≥12 was found at 34 (77.3%) and BATTS <12 scores of 10 (22.7%). For groups with BATSS score ≥12, there were 32 (94.11%) patients. As for the group with BATSS score <12, there were 3 (30%) patients with organ rupture. A validity test of BATSS score obtained showed 91.4% sensitivity, 77.77% specificity, positive predictive value 94.1%, negative predictive value 70%. Conclusion: BATSS can be a tool of early identification and stratification of patients at high risk of the occurrence of intra-abdominal organ injury due to blunt abdominal trauma.
Profile of maxillofacial injuries in Departement of Emergency Trauma and Acute Care Surgery in Sanglah General Hospital from January 2012 to November 2018 Anak Agung Gde Agung Anom Arie Wiradana; Ketut Wiargitha
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.365 KB) | DOI: 10.15562/ism.v10i2.401

Abstract

Introduction: Maxillofacial injuries are common cause of trauma in emergency department. The goals in the treatment of maxillofacial injury are to restore premorbid occlusion. This study aimed to evaluate the characteristics and outcome of the maxillofacial injuries patient in Sanglah General Hospital Denpasar Bali.Methods Retrospective study was held in Sanglah General Hospital from January 2012 to November 2018. The samples consisted of 241 patients. Age, gender, type of the fractures and surgical management were evaluated.Results Maxillofacial injuries mostly occurred in male, aged 18-40 years old, the mandible was most frequently involved facial bone.  Internal fixation was the golden standard of the treatment chosen (83.73%) followed by Arch bar (16.27%).Conclusion Road traffic accidents are the main reason for maxillofacial injury in Sanglah General Hospital Denpasar Bali. Precise diagnosis and proper treatment result in optimal occlusion and integrity nervous system, both internal fixation and arch bar were given good outcome.
Perbedaan nilai Neutrophil Lymphocyte Ratio (NLR) terhadap pemeriksaan kultur darah dalam mendiagnosis sepsis pada pasien peritonitis di RSUP Sanglah, Bali, Indonesia I Putu Gede Sudiartha; I Ketut Wiargitha; Tjokorda Gde Bagus Mahadewa
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (537.4 KB) | DOI: 10.15562/ism.v11i1.571

Abstract

Background: Sepsis is a leading cause of death worldwide. A delayed or missed diagnosis of sepsis could increase its morbidity and mortality. The abdomen is the most common source of sepsis, which known as peritonitis-induced-sepsis. Peritonitis leads to an inflammatory and anti-inflammatory response. This study aims to elaborate on the role of Neutrophil Lymphocyte Ratio (NLR) as an easy, fast and inexpensive infection marker compared to blood culture, which known as the gold standard of sepsis in peritonitis patients. Methods: This is a diagnostic study which combined secondary data taken at Sanglah Hospital Medical Record Department and new cases of generalized peritonitis patients with sepsis who came to Surgical Emergency Unit of Sanglah Hospital as the subjects. A total of 86 subjects, complete blood count analysis was done to calculate NLR. Besides, 2-sided blood culture was tested to see whether the results were positive or negative. Data were analyzed using Stata/SE version 12.1Results: We found that sensitivity of NLR compared to blood culture was 80% (CI:63.1-91.6), with specificity of 88.2% (CI:76.1-95.6), positive predictive value of 82.4% (CI:65.5-93.2), negative predictive value of 86.5% (74.2-94.4), accuracy of 84.9% and likelihood ratio (LR) positive value of 6.8>1. Our results showed that NLR has an enormous value in predicting the occurrence of sepsis in patients with generalized peritonitis. Conclusion: NLR can be used as a screening tool for sepsis in generalized peritonitis patients because it has better sensitivity and accuracy, but it has to confirmed by blood culture as the gold standard. Latar belakang: Sepsis merupakan penyebab kematian diseluruh dunia. Keterlambatan atau kesalahan dalam mendiagnosis dapat menyebabkan peningkatkan morbiditas dan mortalitas. Abdomen merupakan sumber penyebab paling sering terjadinya sepsis yang disebut dengan sepsis diinduksi peritonitis (peritonitis-induced sepsis). Penelitian ini bertujuan untuk menguji kemampuan Neutrophil Lymphocyte Ratio (NLR) sebagai marker infeksi yang mudah, cepat dan murah dibandingkan kultur darah yang merupakan standar baku dalam mendiagnosis sepsis pada pasien peritonitis.Metode: Rancangan penelitan yang digunakan dalam penelitian ini adalah uji diagnostik dengan subjek penelitian  merupakan gabungan antara data sekunder yang diambil di Instalasi Rekam Medis RSUP Sanglah serta identifikasi kasus baru yaitu pasien sepsis pada peritonitis generalisata yang datang ke IRD Bedah RSUP Sanglah sehingga jumlah total sampel 86 orang. Pasien kemudian diambil darah lengkap untuk nilai NLR dan kultur darah 2 sisi apakah hasilnya positif atau negatif. Data dianalisis menggunakan Stata/SE versi 12.1Hasil:   Dari penelitian ini didapatkan sensitifitas NLR dibandingkan dengan kultur darah adalah sebesar 80% (CI: 63,1-91,6) dengan spesifitas 88,2% (CI: 76,1-95,6), nilai prediktif positif 82,4% (CI: 65,5-93,2), nilai prediktif negatif 86,5% (CI: 74,2-94,4) dan akurasi 84,9%, serta nilai likelihood ratio (LR) positif didapatkan 6,8>1. NLR mempunyai nilai yang besar dalam meprediksi terjadinya sepsis pada pasien peritonitis generalisata.Simpulan: NLR dapat digunakan sebagai skrinning pasien sepsis pada peritonitis generalisata karena memiliki sensistifitas dan akurasi yang lebih baik tetapi tetap dikonfirmasi dengan kultur darah sebagai standar baku.
Korelasi antara parameter faal hemostasis dan kadar serum laktat sebagai indikator mortalitas pada pasien multiple trauma di Rumah Sakit Umum Pusat Sanglah Denpasar, Bali-Indonesia Hizkia Robinson Junsen Lumban Gaol; Ketut Wiargitha; Gde Raka Widiana
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.017 KB) | DOI: 10.15562/ism.v11i2.726

Abstract

Background: Trauma is now the most frequent cause of death in the first four decades of life and is still a major public health problem in every country. Trauma that occurs often involves several regions of the body. This condition is called multiple trauma. In multiple trauma, coagulopathy often occurs. In the last four decades it was mentioned that in multiple trauma conditions also occur acidosis and coagulopathy which will also increase the mortality of multiple trauma patients with multiple trauma, serum lactate is superior to base deficit. The purpose of this study is to obtain the correlation of each prothrombin time (PT) value, activated partial prothrombin time (aPTT) value and international normalized ratio (INR) value with serum lactate levels as indicators of mortality in multiple trauma cases.Methods: This study was an observational study with an analytic cross-sectional design to determine the correlation between physiological parameters of hemostasis and serum lactate in multiple trauma patients.Results: From the 60 samples studied there were 43 male patients (71.7%) and 17 female patients (28.3%) with an average age of 37 ± 19.61 years. 7 (11.7%) cases died. Logistic regression test with each conducted on the APPT and INR variables and lactate levels obtained aPTT was the most influential risk factor for mortality with a p-value of 0.005 <0.05 OR 0.023 (CI 95%: 0.002-0.332)Conclusion: Serum lactate levels and physiological hemostasis are not only indicators that explain a patient in a state of shock, but can also be used as an indicator in determining morbidity and mortality in multiple trauma patients.Latar belakang : Trauma saat ini merupakan penyebab kematian paling sering dalam empat dekade pertama kehidupan dan masih menjadi masalah kesehatan masyarakat yang utama di setiap negara. Trauma yang terjadi seringkali melibatkan beberapa regio tubuh. Kondisi ini disebut dengan multipel trauma. Pada multipel trauma, sering terjadi koagulopati.  Pada empat decade terakhir disebutkan bahwa pada multipel trauma juga terjadi keadaan asidosis serta koagulopati yang juga akan meningkatkan mortalitas pasien multipel trauma multipel trauma, serum laktat lebih superior dibanding defisit basa. Tujuan dari penelitian ini adalah didapatkan korelasi masing – masing nilai prothrombin time (PT), nilai activated partial prothrombin time (aPTT) dan nilai international normalized ratio (INR) dengan kadar serum laktat sebagai indikator mortalitas pada kasus multipel trauma.Metode: Penelitian ini merupakan studi observasional dengan rancangan potong lintang analitik untuk mengetahui korelasi antara parameter faal hemostasis dan serum laktat pada pasien multiple trauma.Hasil: Dari 60 sampel yang diteliti dijumpai penderita laki-laki sebanyak 43 orang (71,7 %) dan perempuan 17 orang (28,3 %) dengan rata-rata usia 37 ± 19,61 tahun. Penderita yang meninggal sebanyak 7 (11,7%)  kasus. Uji regresi logistik dengan masing masing dilakukan pada variabel APPT dan INR serta kadar laktat didapatkan aPTT merupakan faktor risiko yang paling berpengaruh terhadap terjadinya mortalitas dengan p-value 0,005 < 0,05 OR 0,023 (IK: 0,002-0,322)Simpulan: Kadar serum laktat dan faal hemostasis tidak hanya sebagai indikator yang menerangkan pasien dalam keadaan syok, tapi juga dapat digunakan sebagai indikator dalam menentukan morbiditas dan mortalitas pada pasien multipel trauma.
Late Diagnosis of Traumatic Diaphragmatic Rupture: Experience in Developing Country Heru Sutanto Koerniawan; Nengah Kuning Atmadjaya; Ketut Wiargitha
Cermin Dunia Kedokteran Vol. 47 No. 10 (2020): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i10.550

Abstract

Diaphragm is a dome-shaped muscular structure that can be divided into right and left hemi-diaphragm. Rupture of diaphragm can be caused by penetrating trauma or blunt trauma to chest and abdomen. A 32 year-old man with sustained traumatic rupture of diaphragm due to blunt abdominal trauma because of traffic accident. Diaphragm repair was performed at the 6th day. Diafragma adalah struktur otot berbentuk kubah yang dapat dibagi menjadi hemi-diafragma kanan dan kiri. Pecahnya diafragma dapat disebabkan oleh trauma tembus atau trauma tumpul pada dada dan perut. Seorang pria 32 tahun dengan trauma pecah diafragma karena trauma tumpul pada perut karena kecelakaan lalu lintas. Perbaikan diafragma dilakukan pada hari ke-6.
Kadar Fibrinogen sebagai Faktor Prediktor Apendisitis Komplikasi Pattipeilohy, Allen Anderson; Wiargitha, I Ketut; Sudarsa, I Wayan
JBN (Jurnal Bedah Nasional) Vol 8 No 1 (2024): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2024.v08.i01.p04

Abstract

Tujuan: Untuk mengetahui apakah kadar fibrinogen tinggi merupakan faktor risiko terjadinya apendisitis akut komplikasi. Metode: Penelitian ini adalah penelitian observasional analitik dengan rancangan kasus kontrol. Sebanyak 32 pasien dengan tanda dan gejala klinis apendisitis akut yang menjalani apendiktomi darurat dan pengukuran kadar fibrinogen serum sebelum operasi dikumpulkan. Sensitivitas dan spesifitas kadar fibrinogen sebagai faktor prediktor dihitung menggunakan kurva receiver operating characteristic (ROC) dan penentuan titik potong dari nilai area under curve (AUC). Diagnosis akhir apendisitis akut komplikasi berdasarkan pada pemeriksaan histopatologi. Analisis statistika meliputi analisis univariat dan bivariat. Hasil: Kelompok dengan apendisitis akut komplikasi (n=16) dan apendisitis akut non-komplikasi (n=16) dikumpulkan. Rerata serum fibrinogen yang terbukti mengalami apendisitis akut komplikasi secara histopatologi adalah 453,13±28,38 mg/dL dibandingkan pada apendisitis non-komplikasi sebesar 356,19±30,89 mg/dL. Titik potong yang ditetapkan adalah 392,5 mg/dL yaitu memiliki sensitivitas 93,8%, spesifisitas 93,7% dan akurasi sebesar 98,4% dan signifikan secara statistik (p<0,001). Terdapat hubungan bermakna antara fibrinogen serum tinggi dengan apendisitis akut komplikasi, dengan OR=225 (IK95%=12,8-3939; p<0,01). Kesimpulan: Dalam diagnosis apendisitis akut komplikasi, penggunaan fibrinogen serum dapat menjadi reaktan diagnostik fase akut yang baru dengan kemungkinan berperan dalam meningkatkan kepastian penegakan diagnosis pasien apendisitis akut.
Late Diagnosis of Traumatic Diaphragmatic Rupture: Experience in Developing Country Heru Sutanto Koerniawan; Nengah Kuning Atmadjaya; Ketut Wiargitha
Cermin Dunia Kedokteran Vol 47 No 10 (2020): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i10.550

Abstract

Diaphragm is a dome-shaped muscular structure that can be divided into right and left hemi-diaphragm. Rupture of diaphragm can be caused by penetrating trauma or blunt trauma to chest and abdomen. A 32 year-old man with sustained traumatic rupture of diaphragm due to blunt abdominal trauma because of traffic accident. Diaphragm repair was performed at the 6th day. Diafragma adalah struktur otot berbentuk kubah yang dapat dibagi menjadi hemi-diafragma kanan dan kiri. Pecahnya diafragma dapat disebabkan oleh trauma tembus atau trauma tumpul pada dada dan perut. Seorang pria 32 tahun dengan trauma pecah diafragma karena trauma tumpul pada perut karena kecelakaan lalu lintas. Perbaikan diafragma dilakukan pada hari ke-6.
Co-Authors Adityas Sukmadi Karjosukarso Anak Agung Gde Agung Anom Arie Wiradana Bianca Jeanne Desy Permatasari Dewi Prima Christian Dian Megasafitri Hizkia Robinson Junsen Lumban Gaol I Gde Raka Widiana I Gede Parwata I Gede Suwedagatha I Komang Yose Antara I Nengah Kuning Atmajaya I Putu Gede Sudiartha I W. Sudarsa Inge Kurniawati Jasmine Stephanie Christian Ketut Sudiasa Koerniawan, Heru Sutanto Nova Juwita Nyoman Golden Pattipeilohy, Allen Anderson Putu Anda Tusta Adiputra Sessy Arie Margareth, Sessy Arie Sri Maliawan Tjokorda Gde Bagus Mahadewa