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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Narra J
Elisabet, Adinda
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Mortality and associated factors among community-acquired pneumonia patients: A cross-sectional study in a provincial referral hospital in Indonesia Rosdiana, Dani; Siregar, Fajri M.; Ediwi, Nabila C.; Putri, Rahmi T.; Nurrahma, Zuyyina ER.; Elisabet, Adinda; Sarassari, Rosantia; Safari, Dodi; Ilmiawati, Cimi; Elliyanti, Aisyah
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1649

Abstract

Community-acquired pneumonia (CAP) poses a significant impact on the healthcare system due to rehospitalization and mortality. About one-third of hospitalized CAP patients died within one year. In addition to advanced age, vulnerable groups with comorbidities such as cancer, diabetes, and cerebrovascular disease (CVD) are more likely to suffer from severe CAP. The aim of this study was to investigate the factors linked to mortality in adult hospitalized CAP patients. The study extracted the medical records of patients aged ≥18 years, admitted to a referral hospital in Riau Province, who were diagnosed with CAP between January and December 2023. Multiple logistic regression step-wise analysis was employed to determine the factors associated with mortality in CAP patients. The study involved 334 patients with a median age of 58 years. Based on the confusion, urea, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score, 11.9% of patients had severe CAP (CURB-65 scores 3 and 4). Age was a significant predictor of severe CAP (p≤0.001). The most prevalent comorbidities were malignancy (33.2%), CVD (30.2%), and diabetes (28.4%). Mortality incidence during hospitalization reached 35.9%. Significant factors associated with mortality in hospitalized CAP patients included renal dysfunction/elevated serum urea levels (p=0.031), CURB-65 score (p=0.023), vasopressor use (p≤0.001), mechanical ventilator use (p≤0.01) and steroid use (p=0.029). However, CVD was associated with a decreased risk of mortality (p=0.019). Gram-negative bacteria predominated, accounting for 50.6% of all positive isolates.  Several significant factors were associated with mortality in adult patients hospitalized with CAP at referral Hospital in Riau, including renal dysfunction, CURB-65 score, vasopressor use, mechanical ventilator use, and steroid use. This finding underscored the importance of early identification factors in CAP patients.
COVID-19 dan Tuberkulosis Paru, Antara Koinfeksi dan Reaktivasi dari Laten Tuberkulosis: Sebuah Kajian Sistematis Simanjuntak, Arya Marganda; Yovi, Indra; Marbun, Patricia Dean Ully; Elisabet, Adinda
Majalah Kedokteran Indonesia Vol 73 No 2 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.2-2023-1006

Abstract

Introduction: Globally, cases of pulmonary tuberculosis (PTB) are rising by 4%, while new cases have declined in many nations, most notably by 14% in Indonesia. During the COVID-19 pandemic, the number of undiagnosed and untreated PTB patients could rise and infect more people. In particular, CD8+ lymphocytes were decreased in COVID-19. Perhaps this is the cause of the rise in cases, but there is no data to show it. Aim: Determine current data about the PTB with COVID-19 coinfection and possible reactivation of PTB after COVID-19 infection in LTB patient. Methods: This systematic review is based on PRISMA statements using Pubmed, EBSCOHost, Science Direct and Cochrane from December 2019 to July 2022. Inclusion and exclusion criteria were set to select studies that included. We analyze risk of bias of all included studies with JBI critical appraisal tools. Results: This study had 107,425 patients in total from 20 studies. All studies were deemed to have low overall author bias risks. A critical component of PTB defense is CD8+. By reducing lymphocytes, COVID-19 can encourage the growth of PTB, which might therefore result in coinfection or the reactivation of existing PTB. Conclusion: COVID-19 possibly increase case of PTB in form of co-infection or reactivation of PTB in LTB patients. This needs special attention for patients that have infected by COVID-19 to followed up for risk developing PTB.
Co-Authors Aisyah Elliyanti Cimi Ilmiawati, Cimi Dani Rosdiana Ediwi, Nabila C. INDRA YOVI Marbun, Patricia Dean Ully Nurrahma, Zuyyina ER. Putri, Rahmi T. Safari, Dodi Sarassari, Rosantia Simanjuntak, Arya Marganda Siregar, Fajri M.