Adi Utomo Suardi
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

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Impact of Comorbidity on Length of Stay of Hospitalized Pneumonia in Children Suardi, Adi Utomo; Turbawati, Dewi Kartika
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

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 Background: The incidence of pneumonia in children under-five in West Java is high. The average length of stay (LOS) often exceeds the standards set by the Indonesia-Disease Related Group (INA-DRG) because of the comorbidities. It can cause financial loss for the hospital. This study was conducted to analyze the impact of comorbidity on LOS.Methods: Data was collected from medical records of 296 hospitalized pneumonia under-five children in the Department of Child Health Dr. Hasan Sadikin General Hospital Bandung in the period from January–December 2012 that consisted of patient’s identity, LOS, primary diagnosis, and comorbid diagnosis. Data was selected through inclusion and exclusion criteria and statistically analyzed using the chi-square and  Spearman correlation test.Results: Out of 218 subjects, those who had major comorbidities and minor comorbidities was 79 (36.2%) and 39 (17.9%), respectively. The average LOS of those who had major  and minor comorbidities was 8.33±8.252 days and 5.95±3.554 days, respectively. Congenital heart disease had the highest and most significant Risk Ratio (RR) with average LOS was 8.00±4.889 days with RR: 1.895 (95% CI:1.339–2.682, p=0.001).Conclusions: Subjects have higher average LOS than the LOS set by the INA-DRG. Congenital heart disease is the most common comorbidity and has the highest and the most significant risk ratio. [AMJ.2017;4(1):42–6]DOI: 10.15850/amj.v4n1.1019
Kematian Akibat Pneumonia Berat pada Anak Balita Wulandari, Diah Asri; Sudarwati, Sri; Suardi, Adi Utomo; Ghrahani D. M., Reni; Kartasasmita, Cissy B.
Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pneumonia merupakan penyebab utama kesakitan dan kematian pada anak, terutama di negara berkembang. Angka kematian karena pneumonia di negara berkembang 10–15 kali lebih tinggi daripada di negara maju. Penelitian ini bertujuan untuk mengetahui angka kematian dan faktor risiko pada anak balita yang dirawat di rumah sakit karena pneumonia. Penelitian potong lintang ini dilakukan pada anak usia 1–59 bulan yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung karena pneumonia periode November 2007─Januari 2009. Tiga ratus delapan belas anak ikut serta dalam penelitian ini. Usia median anak 11‚6 bulan, sebanyak 237 (74‚5%) di antaranya berusia ≤12 bulan. Sembilan puluh tiga (29‚2%) anak didiagnosis pneumonia sangat berat dan 225 (70‚8%) anak pneumonia berat. Dua puluh tiga (7‚2%) penderita meninggal selama perawatan, 20 di antaranya dirawat dengan pneumonia sangat berat (p<0,001; OR 20,274; 95%IK: 5,855–70,197). Kelainan jantung bawaan (p=0,002; OR 5,795; 95%IK: 2,115–15,407) dan leukositosis (≥15.500/mm3; p=0,002; OR 3,879; 95%IK: 1,547–9,727) berhubungan erat dengan kematian. Kuman patogen ditemukan pada 11 dari 23 penderita yang meninggal. Simpulan, kematian karena pneumonia berat masih cukup tinggi. Pneumonia sangat berat, kelainan jantung bawaan, dan leukositosis merupakan faktor risiko yang meningkatkan kematian anak balita dengan pneumonia. [MKB. 2013;45(1):50–5]Mortality Due to Severe Pneumonia in Under-Five Years Old ChildrenPneumonia is one of the leading causes of morbidity and mortality in children, mainly in developing countries with a 10–15 times higher mortality rate than developed countries. The aim of the study was to know the mortality rate and its risk factors among under five years old children who were hospitalized due to severe pneumonia. This cross-sectional study was conducted to 1 to 59 months old children with pneumonia at the Department of Pediatric Dr. Hasan Sadikin Bandung Hospital from November 2007 to January 2009. Three hundred and eighteen children were enrolled in this study. The median age was 11.16 months, and 237 (74.5%) were ≤12 months of age. Very severe pneumonia was diagnosed in 93 (29.2%) and severe pneumonia in 225 (70.8%) children. Twenty three (7.2%) children died during hospitalization, 20 were hospitalized with very severe pneumonia (p<0.001, OR 20.274, 95%CI: 5.855─70.197). Congenital heart disease (p=0.002, OR 5.795, 95%CI: 2.115–15.407) and leucocytosis (≥15,500/mm3, p=0.002, OR 3.879, 95%CI: 1.547–9.727) were significantly associated to the mortality. Pathogenic bacteria were identified in 11 of 23 patients. In conclusions, the mortality of severe pneumonia is still high. Very severe pneumonia, congenital heart disease and leucocytosis are factors that increase mortality among under-five years old children with pneumonia. [MKB. 2013;45(1):50–5] DOI: http://dx.doi.org/10.15395/mkb.v45n1.140