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All Journal Respiratory Science Public Health and Safety International Journal (PHASIJ) Indonesian Health Journal Jurnal Multidisiplin Indonesia Indonesian Journal of Global Health Research
Syamsul Bihar
Department Of Pulmonolgy And Respiratory Medicine, Faculty Of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
Dentistry Education Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary

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Accuracy Between CURB-65 Score and PSI in Determining The Prognosis of Community-Acquired Pneumonia Patients at H. Adam Malik General Hospital, Medan Fransisco Sentosa Pakpahan; Syamsul Bihar; Fajrinur Syarani; Putri Chairani Eyanoer
Respiratory Science Vol. 1 No. 3 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i3.25

Abstract

Background: Community-Acquired Pneumonia (CAP) is an important problem associated with morbidity and mortality. An accurate initial assessment is required before starting management of a CAP patient to determine the prognosis of the patient as early as possible. The CURB-65 score and PSI (Pneumonia Severity Index) are initial assessment scores that can be used. This study aimed to compare the accuracy between the CURB-65 score and the PSI in determining the prognosis in CAP patients at H. Adam Malik General Hospital Medan. Method: A descriptive study was conducted on 76 patients diagnosed with CAP. Each patient was assessed for their CURB-65 score, PSI class and mortality within 30 days of admission. Data were collected through patient medical records diagnosed CAP in 2018 and performed statistical analysis using 2x2 tables. Results: The CURB-65 ≥3 score showed accuracy (71.0%), sensitivity (53.8%), and specificity (89,2%). The CURB-65 ≥ 2 score showed accuracy (75.0%), sensitivity (82.1%), and specificity (67.6%).  Meanwhile, the Class IV-V PSI showed accuracy (77.6%), sensitivity (87.2%) and specificity (67.6%). Conclusion: The accuracy of the PSI is higher when compared to the CURB-65 score in determining the prognosis of CAP patients at H. Adam Malik General Hospital Medan. Although PSI is more accurate, CURB-65 is simpler, easier and less expensive to use
CT Guided TTNA and Core Biopsy in Suspected Lung Cancer, Review of Cases in Adam Malik General Hospital, Medan Hadi Suhendra; Fajrinur Syarani; Syamsul Bihar; Putri Chairani Eyanoer
Respiratory Science Vol. 2 No. 1 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v2i1.27

Abstract

ounds: The cytological and histopathological findings establish the type of lung cancer cells as the definitive diagnosis of lung cancer. This study aimed to determine the characteristics of lung cancer patients in terms of age, mean age, gender, staging, the proportion of lung cancer cells by cytologic examination of Transthoracic Needle Aspiration (TTNA) and histopathologic evaluation from CT-guided core biopsy. Method: This is a descriptive study involving 42 subjects diagnosed with lung cancer at H. Adam Malik Hospital Medan in 2016-2020 that met the inclusion criteria through consecutive sampling. Data was analysed using descriptive statistics for categorical variables. Results: Of 42 study subjects, the 60–71-year age group had the highest percentage of lung cancer (42.9%). Male (71.4%) was higher than female, the most common lung cancer staging was IVA (57.1%), and adenocarcinoma was found to be the most frequent type of lung cancer in both cytology (33.3%) and histopathology (31.0%). Conclusion: We concluded that core biopsy is superior in diagnosing lung cancer compared to TTNA.
The Associations Between Severity Of Symptoms, D-Dimer and Incidence of ARDS In COVID-19 Herani Mutia Riandini; Fajrinur Syaran; Syamsul Bihar; Putri Chairani Eyanoer
Respiratory Science Vol. 2 No. 3 (2022): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v2i3.40

Abstract

Background: Severe acute respiratory injury caused by COVID-19 (ARDS) is a serious emerging complication. ARDS results from a cytokine storm that occurs in the second week of the disease course and acute-onset hypoxemia can be seen with bilateral infiltrates on chest radiograph. This study aimed to relate the severity of symptoms and D-dimer level to the incidence of ARDS in COVID-19 at H. Adam Malik Hospital as the referral center for COVID-19 in North Sumatra. Method: This was a descriptive study with a retrospective cohort design. The sample of this study was secondary data from medical records of positive RT-PCR COVID-19 patients from November 2020 to April 2021. The inclusion criteria were patients with moderate to critical COVID-19 cases with D-dimer examination taken from the first day of admission. Subjects were then followed up until discharge from the hospital to assess for ARDS episodes which were confirmed by the results of PaO2/FiO2 in arterial blood gases and bilateral infiltrations in chest X-Ray. The exclusion criteria were incomplete medical records. Results: The association between the severity of symptoms and the incidence of ARDS, 1 of which was found to be moderate, 19 cases were severe and 20 were critical. However, there was a statistically significant correlation between the severity of symptoms and the incidence of ARDS (P=0.0001). Conclusion: There was a significant correlation between the severity of symptoms and the D-dimer value on the incidence of ARDS.
Data on Germs Patterns and Sensitivity to Antibiotics in Late Onset Ventilator Associated Pneumonia at ICU Haji Adam Malik Hospital Medan 2024 Dwisa Febrina Ritonga; Fajrinur Syarani; Syamsul Bihar; Taufik Ashar
Jurnal Multidisiplin Indonesia Vol. 5 No. 6 (2026): Jurnal Multidisiplin Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jmi.v5i6.2755

Abstract

Ventilator-associated pneumonia (VAP) is a lung infection that occurs in patients using mechanical ventilators for more than 48 hours, with late-onset VAP posing a high risk of multidrug-resistant pathogens. Data on bacterial patterns and antibiotic sensitivity are crucial for empirical treatment and resistance control. This research aims to identify bacterial patterns and antibiotic sensitivity in late-onset VAP cases at the ICU of Haji Adam Malik Hospital, Medan, in 2024. A cross-sectional study was conducted involving 76 samples. Demographic data, bacterial cultures, and antibiotic sensitivity results, obtained from medical records, were analyzed using SPSS 22.0. Among 75 patients with late-onset VAP, the majority were over 50 years old (63.2%) and male (57.9%). Acinetobacter baumannii (44.7%) and Pseudomonas aeruginosa (15.8%) were the most common pathogens. High resistance to cephalosporins was noted, while colistin, polymyxin B, amikacin, and norfloxacin remained effective. A significant association was found between VAP incidence and the duration of ventilator use (p < 0.001). Acinetobacter baumannii is the dominant pathogen in late-onset VAP, with significant antibiotic resistance. Continuous surveillance of bacterial profiles and resistance patterns is essential to guide effective empirical therapy and infection control.
Hubungan Antara Pola Kuman dengan Mortalitas pada Pasien Pneumonia di IPI RS. HAM Medan Agnes Nadia; Syamsul Bihar; Fajrinur Syarani
Public Health and Safety International Journal Vol. 5 No. 01 (2025): Public Health and Safety International Journal (PHASIJ)
Publisher : YCMM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55642/phasij.v5i01.990

Abstract

Pneumonia is one of the leading causes of morbidity and mortality, partIPIlarly in hospital settings. Identifying bacterial patterns and antibiotic resistance is essential to determine appropriate therapy and reduce mortality rates. This study aimed to examine the association between bacterial patterns, antibiotic resistance, and mortality in pneumonia patients. A retrospective design was used by analyzing medical record data of pneumonia patients treated in 2022. A total of 66 patients who met the inclusion criteria were included in the analysis. Data included sputum culture results, antibiotic resistance profiles, and patient mortality status. The results showed that the most commonly found bacteria were Klebsiella pneumoniae (31.8%), followed by Acinetobacter baumannii (25.8%) and Pseudomonas aeruginosa (16.7%). The highest resistance rates were observed for meropenem (31.8%) and levofloxacin (28.8%). Statistical analysis revealed a significant association between antibiotic resistance and patient mortality (p = 0.017). However, no significant association was found between the type of causative bacteria and mortality (p = 0.414). These findings indicate that antibiotic resistance plays a major role in clinical outcomes of pneumonia patients. Therefore, regular monitoring of bacterial and resistance patterns and the implementation of rational antibiotic use policies are essential to reduce pneumonia-related mortality in hospitals.
Association between Sepsis and Mortality among Patients with Pneumonia Admitted to the Intensive Care Unit Syaela Fitri Nasution; Syamsul Bihar; Ella Rhinsilva; Taufik Ashar
Indonesian Journal of Global Health Research Vol. 8 No. 5 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i5.2336

Abstract

Pneumonia is one of the leading causes of morbidity and mortality worldwide, particularly among patients admitted to the Intensive Care Unit (ICU). This condition is often associated with sepsis, which can worsen prognosis and increase the risk of death. This study aimed to determine the association between demographic characteristics, length of stay, sepsis, and qSOFA score with mortality among pneumonia patients admitted to the Intensive Care Unit. This study was an analytical observational study with a retrospective cohort design using medical record data of pneumonia patients admitted to the ICU at Adam Malik General Hospital Medan. A total of 74 patients who met the inclusion and exclusion criteria were included. Data were analyzed using univariate and bivariate analyses with Chi-square and Fisher’s exact tests. Statistical significance was set at p < 0.05, and the strength of association was measured using Odds Ratio (OR) with a 95% confidence interval. Most patients were aged 56–65 years and >65 years, each accounting for 25.7%, and were predominantly male (59.5%). The most common comorbidity was kidney disease (AKI/CKD) at 33.8%. The mean length of ICU stay was 13.81 ± 7.97 days. Mortality among pneumonia patients with sepsis was 75.7%. There was no significant association between sex and mortality (p=0.698) or age and mortality (p=0.247). A significant association was found between length of ICU stay and mortality (p=0.029). In addition, qSOFA score was significantly associated with mortality (p=0.004), with an OR of 5.409 (95% CI: 1.575–18.577). Length of stay, sepsis, and qSOFA score were significantly associated with mortality among pneumonia patients in the ICU, while demographic characteristics showed no significant association.
The Relationship Between Lactic Acid Levels and Mortality in Patients with Sepsis Pneumonia at H. Adam Malik Hospital Medan in 2023 Senna Oktora Nasution; Syamsul Bihar; Ella Rhinsilva; Rina Amelia
Indonesian Health Journal Vol. 5 No. 3 (2026): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v5i3.949

Abstract

Sepsis associated with pneumonia is a critical condition with a high risk of mortality due to systemic inflammation, tissue hypoperfusion, and progressive organ dysfunction. Serum lactate has been widely recognized as an important biomarker of tissue hypoperfusion and altered cellular metabolism, whereas procalcitonin is commonly used as a biomarker of bacterial infection and systemic inflammatory response. However, evidence regarding the prognostic value of these biomarkers in Indonesian tertiary hospitals remains limited. This study aimed to determine the relationship between serum lactate levels and mortality among patients with sepsis associated with pneumonia at H. Adam Malik Hospital in Medan in 2023 and to compare this relationship with that of procalcitonin levels. This analytical study employed a cross-sectional design using medical record data from patients diagnosed with sepsis associated with pneumonia between January and December 2023. A total of 93 patients who met the inclusion criteria were analyzed. The associations between biomarker levels and mortality were assessed using the chi-square test, with statistical significance set at p < 0.05. Patients with serum lactate levels >2 mmol/L had a higher mortality proportion (91.9%) than those with levels <2 mmol/L (77.4%). Statistical analysis demonstrated a significant association between serum lactate levels and mortality (p = 0.043). In contrast, procalcitonin levels were not significantly associated with mortality (p = 0.600). Elevated serum lactate levels were significantly associated with mortality among patients with sepsis associated with pneumonia and may have potential value as a prognostic marker. Procalcitonin should be interpreted in conjunction with other clinical parameters rather than as a standalone predictor of mortality. Further prospective studies incorporating serial biomarker measurements are recommended.
Co-Authors Agnes Nadia Dwisa Febrina Ritonga Ella Rhinsilva Fajrinur Syaran Fajrinur Syarani Fransisco Sentosa Pakpahan Hadi Suhendra Herani Mutia Riandini Putri Chairani Eyanoer, Putri Chairani Rina Amelia Senna Oktora Nasution Syaela Fitri Nasution Taufik Ashar