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All Journal Medical Journal of Indonesia Narra J
Pradhevi, Lukita
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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More severe comorbidities, advanced age, and incomplete vaccination increase the risk of COVID-19 mortality Pradhevi, Lukita; Soegiarto, Gatot; Wulandari, Laksmi; Lusida, Michael AP.; Saefudin, Rendra P.; Vincent, Agustinus
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.949

Abstract

Numerous studies have stated that comorbidities are risk factors for coronavirus disease 2019 (COVID-19) mortality, but few have considered the severity or stage of these comorbidities. The aim of this study was to determine the association between the severity of comorbidity, age, and number of COVID-19 vaccinations with COVID-19 mortality. This case-control study was conducted from July 2021 until December 2022 at the Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The patients were divided into non-survived patients (case group) and survived patients (control group). The inclusion criteria for cases were adult patients hospitalized with confirmed COVID-19, based on reverse transcriptase-polymerase chain reaction (RT-PCR) testing of nasopharyngeal swabs. Using total sampling, 1,046 confirmed COVID-19 patients, which consisted of 450 (43%) non-survived patients and 596 (57%) survived patients, were included. The most common comorbidity was diabetes mellitus (DM) (82.7%), chronic kidney disease (CKD) (43%), hypertension (25.7%), and obesity (23.6%). Our multivariate analysis indicated that older age (aOR: 1.03; 95%CI: 1.02–1.04, p<0.001), male sex (aOR: 1.29; 95%CI: 1.11–2.00, p=0.007), severe COVID-19 at first admission (aOR: 3.13; 95%CI: 2.08–4.73, p<0.001), having pneumonia (aOR: 1.99; 95%CI: 1.21–3.33, p=0.005), poorly controlled DM with HbA1c≥9% (aOR: 2.90; 95%CI: 1.72–4.89, p<0.001), severe obesity with body mass index (BMI)≥30 (OR: 2.90; 95%CI: 1.72–4.89, p<0.001), hypertension stage 2 (aOR: 1.99; 95%CI: 1.12–3.53, p=0.019) or stage 3 (aOR: 6.59; 95%CI: 2.39–18.17, p<0.001), CKD stage 3 (aOR: 2.50; 95%CI: 1.36–4.59, p=0.003), stage 4 (aOR: 5.47; 95%CI: 2.18–13.69, p<0.001) or stage 5 (aOR: 1.71; 95%CI: 1.04–2.81, p=0.036), and having chronic lung disease (aOR: 3.08; 95%CI: 1.22–7.77, p=0.017) significantly increased the risk of COVID-19 mortality. In contrast, COVID-19 vaccination reduced the risk of COVID-19-associated death. This study highlights that more severe comorbidities, advanced age, and incomplete vaccination were associated with COVID-19 mortality.
Diabetic foot score: a predictive model for leg amputation in patients with diabetic foot disease Vincent, Agustinus; Soelistijo, Soebagijo Adi; Ardiany, Deasy; Pranoto, Agung; Lusida, Michael Austin Pradipta; Pradhevi, Lukita; Saefudin, Rendra Prasetya
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247427

Abstract

BACKGROUND Patients with diabetes mellitus are at a higher risk for peripheral artery disease (PAD) and diabetic foot disease (DFD), which can ultimately result in leg amputation. This study aimed to develop a novel scoring system to predict the risk of leg amputation using widely available modalities, including demographic characteristics and various laboratory data. METHODS This study was conducted at Dr. Soetomo General Hospital and analyzed risk factors for leg amputation in 99 patients with DFD who underwent leg amputation compared with 80 control patients. This study presented a predictive model for leg amputation in patients with DFD, using odds ratio (OR) analysis and logistic regression approach with confidence intervals (CIs) set at 95%. The data analysis was conducted using SPSS software version 25.0. RESULTS PAD (OR 6.52, 95% CI = 2.19–19.37, p = 0.001), high low-density lipoprotein cholesterol (OR 5.97, 95% CI = 2.31–15.43, p<0.001), type of DFD (OR 4.58, 95% CI = 2.14–9.79, p<0.001), poor glycemic control (OR 4.48, 95% CI = 1.78–11.28, p = 0.001), and neutrophil-to-lymphocyte ratio level (OR 1.04, 95% CI = 1.00–1.07, p = 0.025) were the independent predictors for leg amputation. The predictive model, developed using multivariate analysis with an area under the curve of 89%, optimum threshold of 0.5 (score 6), sensitivity of 84.8%, and specificity of 78.8%, indicating a promising approach for predicting leg amputation outcomes. CONCLUSIONS The newly developed diabetic foot score may assist in making decisions regarding therapeutic options for patients with DFD.
Co-Authors Agung Pranoto Ardiany, Deasy Gatot Soegiarto Laksmi Wulandari Lusida, Michael AP. Lusida, Michael Austin Pradipta Saefudin, Rendra P. Saefudin, Rendra Prasetya Soelistijo, Soebagijo Adi Vincent, Agustinus