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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Jurnal Penyakit Dalam Indonesia
Sari, Nina Kemala
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Neuroscience Public Health

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Kesintasan Pasien Karsinoma Hepatoselular: Sebuah Studi Komprehensif tentang Pengaruh Awitan Dini versus Lambat dan Faktor Determinannya Achmad, Ibrahim; Jasirwan, Chyntia Olivia Maurine; Rajabto, Wulyo; Abdullah, Murdani; Nababan, Saut Horas H.; Nasution, Sally Aman; Koesnoe, Sukamto; Sari, Nina Kemala
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. The prognosis for patients with Hepatocellular Carcinoma (HCC) is generally poor because most cases are diagnosed at an advanced stage. Several studies indicate that HCC is more prevalent and has a worse prognosis among younger individuals. This study aims to identify and compare the variations in survival rates between early and late-onset HCC patients at Cipto Mangunkusumo Hospital and investigate the factors that impact survival outcomes in both groups. Methods. Retrospective cohort study of HCC patients registered in HCC registry 2015-2022. Survival was visualized using Kaplan-Meier curves. Prognostic factor variables in the Cox Proportional Hazard Regression analysis by backward method in the final model became independent prognostic factors for overall survival. Results. There were 896 subjects. Patients with early onset had a median survival of 2.0 months (95% CI 1.0-2.9), while late-onset patients had a median survival of 4.0 months (95% CI 3.4-4.5) (p=0.021). During the observation period, the incidence of death in early onset was found to be higher compared to late onset (92.9% vs. 87.7%, p 0.032). In the multivariate analysis for early onset, hypertension comorbidity and lack of hepatitis treatment were prognostic factors increasing the risk of death with [HR 3.7 (95% CI: 1.0-12.7)] and [HR 2.4 (95% CI: 0.9-6.2)] (p=0.053). In the multivariate analysis for late onset, prognostic factors increasing the risk of death include AFP levels ≥200 ng/mL [HR 1.2 (95% CI: 1.0-1.5)], liver cirrhosis [HR 1.2 (95% CI: 1.0-1.3)], AJCC stage 4 as the most advanced stage [HR 4.5 (95% CI: 2.2-8.9)], supportive therapy [HR 5.2 (95% CI: 3.9-6.8)], and palliative therapy [HR 1.6 [95% CI: 1.2-2.2)]. Conclusion. The median survival of early-onset HCC patients is lower compared to late-onset ones because the majority are not given curative treatment. Independent prognostic factors in early-onset are hypertension and hepatitis treatment, while in late-onset AFP levels, liver cirrhosis, AJCC stage, and therapy are given.
VALIDITY, RELIABILITY, AND DIAGNOSTIC PERFORMANCE OF GERIATRIC-8 AS A SCREENING TOOL FOR ABNORMAL COMPREHENSIVE GERIATRIC ASSESSMENT Dibyantari, Ridzqie; Sari, Nina Kemala; Wahyudi, Edy Rizal; Muhadi; Rizka, Aulia; Mansjoer, Arif; Sutandyo, Noorwati
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 13 No. 2 (2026): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jkk.v13i2.728

Abstract

The Geriatric Patient Plenary Assessment (P3G) is useful in the management of the elderly, but it is time-consuming, so screening instruments such as the Geriatric 8 (G8) have been developed. Initially designed for cancer patients, the G8 has also been shown to be valid in non-cancer elderly patients, but there have been no studies in Indonesia. This cross-sectional study (August 2023–March 2024) at the Geriatrics Clinic of Cipto Mangunkusumo National Hospital involved 80 subjects who underwent P3G and G8. An abnormal P3G was defined as impaired in ≥1 domain (ADL <20, IADL <8, MNA <24, MoCA-INA <26, or GDS >4). The results showed strong reliability (inter-rater kappa 1; intra-rater 0.904; ICC 0.77–1; Cronbach's α 0.697). The G8 had a sensitivity of 70.27% and a specificity of 83.33%, with an AUC of 0.846 (p<0.005). These findings demonstrate good diagnostic performance in identifying elderly individuals requiring a complete P3G. It is concluded that the G8 is valid and reliable as a screening tool for elderly individuals in the general Indonesian population, with good specificity.
Co-Authors Achmad, Ibrahim Arif Mansjoer Aulia Rizka, Aulia Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Dibyantari, Ridzqie Edy Rizal Wahyudi Muhadi Murdani Abdullah Nababan, Saut Horas H. Noorwati Sutandyo Sally Aman Nasution, Sally Aman Sukamto Koesnoe Wulyo Rajabto