Siti Taqwa Fitria Lubis, Siti Taqwa Fitria
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Perbandingan Skor DECAF dengan Skor BAP-65 terhadap Kematian dalam Tiga Puluh Hari pada Pasien PPOK Eksaserbasi Akut di RSUP H. Adam Malik Medan Lubis, Siti Taqwa Fitria; Keliat, E. N.; Abidin, Alwinsyah
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (208.821 KB) | DOI: 10.15395/mkb.v48n1.727

Abstract

Pada penderita penyakit paru obstruksi kronik (PPOK) eksaserbasi akut, penilaian derajat keparahan pada awal masuk penting dalam menentukan risiko kematian rawat inap rumah sakit, memutuskan perawatan bangsal atau Intensive Care Uni,t dan penatalaksanaan selanjutnya. Skor Dyspnoea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) dan skor elevated BUN, Altered mental status, Pulse 109 beats/min, age >65 years (BAP-65) dapat digunakan sebagai alat prognostik. Penelitian ini bertujuan membandingkan skor DECAF dengan skor BAP-65 memprediksi kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Penelitian dengan desain kohort, subjek adalah pasien PPOK eksaserbasi akut di Instalasi Gawat Darurat dan rawat inap RSUP H. Adam Malik Medan, pada bulan Februari–Juni 2013. Dinilai skor DECAF dan skor BAP-65. Dihitung sensitivitas dan spesifisitas kedua skor dan dibandingkan kekuatannya. Sebanyak 40 subjek direkrut, rata-rata (±SB) usia 61,07±12,42 tahun. Sembilan subjek (23%) meninggal saat penelitian. Uji chi-kuadrat mendapatkan hasil signifikan skor DECAF p 0,003 dan skor BAP-65 p=0,0026. Sensitivitas dan spesifisitas skor DECAF dan skor BAP-65, masing-masing 100% dan 16%, 100% dan 39%. Simpulan, skor DECAF dan skor BAP-65 memiliki hubungan dengan kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Tingginya sensitivitas dan rendahnya spesifisitas menyebabkan kedua skor ini belum dapat digunakan sebagai alat prognostik. Diperlukan penelitian dengan subjek yang lebih besar untuk mendapatkan keakuratan kematian. [MKB. 2016;48(1):7–14]Kata kunci: PPOK eksaserbasi akut, prognosis, skor BAP-65, skor DECAFComparison between DECAF Score and BAP-65 Score in Predicting Thirty Days Mortality in Acute Exacerbations COPD Patients in H. Adam Malik General HospitalAbstractThe assessment of severity level in patient with acute exacerbation chronic obstructive pulmonary disease (AECOPD) at early admission is important to determine the risk of in-hospital mortality, to decide hospitalization or requirement of Intensive Care Unit setting and further management. Dyspnea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) score, and elevated BUN. Altered mental status, pulse 109 beats/min, age >65 years (BAP-65) can be used as prognostic tools. The aim of this study was to investigate the comparison between DECAF score and BAP-65 score in predicting 30 days-mortality in AECOPD patients. This was a cohort study, subjects were AECOPD patients in emergency unit and inpatient in H. Adam Malik General Hospital, from February to June 2013. DECAF score and BAP-65 score were assessed. We calculated sensitivity and specificity of both scores to compare the stronger predictor. Fourty subjects were recruited, mean (±SD) age was 61.07±12.42 years. Nine subjects (23%) died during the study. This study presented significant result with p=0,003 for DECAF score and p=0,0026 for BAP-65 score, using chi-square test. Sensitivity and specificity of DECAF score and BAP-65 score were 100% and 16%, 100% and 39%, respectively. In conclusion, DECAF score and BAP-65 score have correlations with 30-days mortality in AECOPD patients. High sensitivity and low specificity prevent the use of these scores as prognostic tools. A larger study is required to determine the accuracy on mortality. [MKB. 2016;48(1):7–14]Key words: Acute exacerbation COPD, BAP-65 score, DECAF score, prognostic
Efektivitas Vaksin COVID-19 mRNA Booster Kedua pada Tenaga Kesehatan di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo dan Faktor yang Memengaruhinya Lubis, Siti Taqwa Fitria; Koesnoe, Sukamto; Yunihastuti, Evy; Shatri, Hamzah; Karjadi, Teguh Harjono; Harimurti, Kuntjoro; Pitoyo, Ceva Wicaksono; Yunir, Em
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. The emergence of the Omicron variant during the pandemic had an impact on the effectiveness of the COVID-19 vaccine. The spread of Omicron increased rapidly even in populations that had been vaccinated with booster doses, causing a high incidence of infection. This study aimed to determine the effectiveness and factors related to the effectiveness of the second mRNA booster vaccine as well as antibody levels after the second mRNA booster vaccine in healthcare workers at Cipto Mangunkusumo National General Hospital. Methods. This study used a cohort design. Total sampling of 271 healthcare workers were obtained from previous research and continued with consecutive sampling. Selected subjects were interviewed, and blood samples were taken to measure IgG sRBD antibody levels. The effectiveness of the vaccine was calculated, and bivariate and multivariate analysis was carried out to assess the factors that influenced the effectiveness of the second mRNA booster vaccine. Results. A total of 9 subjects (5.6%) were infected with COVID-19 in the second booster vaccine group and 11 subjects (9.7%) in the first vaccine group. The effectiveness of the vaccine against COVID-19 infection was 42% (CI 95% -37 – 75%), p = 0,215. Age, gender, hypertension, type 2 DM, obesity, smoking, and COVID-19 infection before booster have no relationship to the effectiveness of the second booster mRNA vaccine. In 48 subjects who had their antibody levels checked during the first and second boosters, there was an increase from 4,743 AU/ml (IQR 6,053.3) to 8,532 AU/ml (IQR 8,040.3). Conclusions. The effectiveness of the second mRNA booster vaccine against COVID-19 infection in healthcare workers was 42%. There were no factors related to the effectiveness of the second mRNA booster vaccine. The sRBD antibody levels after the second booster vaccine were higher than the first booster vaccine.