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All Journal JURNAL KEBIDANAN KESTRA (JKK) JURNAL FARMASIMED (JFM)
INDRA TARIGAN, INDRA
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Medicine & Pharmacology

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The Effect of Speed of Intervention in Hyperglycemic Emergencies on Patient Mortality Tarigan, Indra
JURNAL KEBIDANAN KESTRA (JKK) Vol. 6 No. 1 (2023): Jurnal Kebidanan Kestra (JKK)
Publisher : Fakultas Kebidanan Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/jkk.v6i1.2533

Abstract

Hyperglycemic emergencies, such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia (HHS), are potentially fatal conditions if not treated immediately. The speed of medical intervention plays an important role in determining patient clinical outcomes, including the risk of mortality. However, there are still limitations in research on the relationship between the speed of intervention and patient mortality rates. This study aims to analyze the effect of the speed of medical intervention in hyperglycemic emergencies on patient mortality, as well as to determine the factors that contribute to patient clinical outcomes. This study used an observational analytical design with a retrospective approach to medical record data of patients with a diagnosis of hyperglycemic emergencies in the emergency unit of a hospital within a certain period. The main variables analyzed were the time of initial intervention after patient arrival and mortality. Data analysis was performed using descriptive statistics for univariate data and the chi-square test and logistic regression for bivariate and multivariate analysis. Univariate analysis showed that the majority of patients experienced a delay in intervention of more than 1 hour since arrival at the hospital. Bivariate analysis showed a significant relationship between the speed of intervention and patient mortality (p < 0.05). The results of logistic regression showed that patients who received intervention in less than 1 hour had a lower chance of dying compared to patients who received intervention later (OR = 2.5; 95% CI: 1.4-4.5). Other factors such as age, comorbidities, and initial blood glucose levels also have an effect on patient mortality. The speed of intervention in hyperglycemic emergencies has a significant effect on patient mortality. Faster intervention is associated with a decreased risk of death. Therefore, it is necessary to increase awareness of medical personnel regarding the importance of early detection and rapid response in treating patients with acute hyperglycemic conditions.
Study on the Effectiveness of Thrombolytic Drugs in Emergency Treatment of Ischemic Stroke: Time and Outcome Analysis Tarigan, Indra
Jurnal FARMASIMED (JFM) Vol 6 No 2 (2024): Jurnal Farmasimed (JFM)
Publisher : Fakultas Farmasi Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/jfm.v6i2.2506

Abstract

Ischemic stroke is one of the leading causes of morbidity and mortality worldwide. Thrombolytic therapy, such as the use of alteplase (tPA), is an effective standard of care when given in a timely manner. However, its effectiveness in clinical practice still varies, especially related to factors such as the time of drug administration and patient clinical outcomes. This study aims to analyze the effectiveness of thrombolytic drugs in ischemic stroke emergencies based on the relationship between the time of drug administration and patient clinical outcomes, using univariate and bivariate analysis. This study used an observational analytical design with a retrospective approach. Data on ischemic stroke patients who received thrombolytic therapy were collected from medical records at the hospital during a certain period. The independent variables included onset-to-needle (OTN) time and door-to-needle (DTN) time, while the dependent variable was clinical outcome based on the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Univariate analysis was used to describe the distribution of patient characteristics and main variables, while bivariate analysis was performed with correlation and logistic regression tests to see the relationship between the time of drug administration and patient outcomes. The results of univariate analysis showed that the majority of patients (70%) received thrombolysis within the OTN time range <3 hours, with an average initial NIHSS value of 12.5 ± 4.3. From the bivariate analysis, a significant relationship was found between DTN time <60 minutes and improvement in NIHSS score after 24 hours (p <0.05). In addition, patients with mRS <2 at 90 days after therapy were more common in the group receiving thrombolytics faster (OTN <3 hours) than those who received slower (p <0.01).
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