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All Journal Neurona Journal of Neurointervention and Stroke (JNeViS)
Octavinawaty, Lenny
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Health Professions Medicine & Pharmacology Neuroscience

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FAKTOR-FAKTOR YANG MEMPENGARUHI NYERI KEPALA PASKA ENDOVASKULAR COILING PADA PERDARAHAN SUBARAKHNOID Puspita Ratnasari, Nurlia; Desti Ramadhoni, Pinto; Sugiharto, Henry; Octavinawaty, Lenny; Haswatty, Bayu
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.456

Abstract

Introduction: Post endovascular coiling headache, according to ICHD-3, defined as a new headache due to coiling embolization which is still felt by aneurysm rupture subarachnoid patients 3 months after the procedure, which other acute SAH-related headaches have been ruled out. A previous prospective study showed that 50% unruptured aneurysms patients who undergo endovascular coiling experience headache. However, there are currently no studies on headache after endovascular coiling in ruptured aneurysms. Aim: To identify the factors that influence post-endovascular coiling headache in subarachnoid hemorrhage patients with aneurysm rupture. Method: Retrospective cohort study, using medical record data at RSUP Dr. Mohammad Hoesin Palembang. Headache intensity was assessed using the Numerical Pain Rating Scale at 3 months after the procedure according to the ICHD-3 standard. Results: Most patients were > 50 years old, female (60.5%), had a history of hypertension (81.40%), Hunt and Hess grade 2 (41.9%), mFisher grade I (41.9%), located in ICA ( 34.9%), aneurysm diameter 5 mm (69.8%), onset of action at 10 days (58.1%), mRRC class I (53.5%) and Packing Attenuation 25% (53.5%). It was found that 50% of the subjects experienced mild headache after endovascular coiling. In bivariate analysis, it was found that Hunt and Hess 4-5 (p=0.048) and Packing Attenuation >25% (p=0.03) had a significant relationship with incidence of post-endovascular coiling headache. Discussion: Severe Hunt and Hess grade (4-5) and high packing attenuation (> 25%) are associated with the incidence of post-endovascular coiling headache in aneurysm rupture SAH patients Keywords: Subarachnoid haemorrhage, aneurysm rupture, Endovascular coiling, Headache
FAKTOR-FAKTOR YANG MEMPENGARUHI LUARAN PADA PASIEN PERDARAHAN SUBARAKHNOID: PENELITIAN COHORT PROSPEKTIF 18 BULAN Muhlisa, Safitri; Ramadhoni, Pinto Desti; Junaidi, Achmad; Octavinawaty, Lenny; Adwirianny, Ashita Hulwah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.451

Abstract

Introduction: Subarachnoid hemorrhage (SAH) is an acute bleeding in the subarachnoid space. The mortality rate of SAH is quite high and survivors will experience limitations in activity daily living. Identification and factors that affect SAH are needed to improve patient outcomes. Aim: to identify the factors that affect the mortality of SAH Methods: This study was an observational study with a prospective cohort approach regarding the factors that affect the outcome of subarachnoid hemorrhagic patients in Dr. Mohammad Hoesin Hospital Palembang from January 2021 to July 2022. Results: From 62 subjects, the patients were 55.35 (SD ± 12.4) years old in average, most of them were female (67.7%). About 87.1% of patients had GCS> 8 (mean 11.68, SD ± 3.273). There were 82.3% of patients with mild-moderate NIHSS (mean 11.68; SD ± 3.273). The mortality rate was 37.1% (n = 23) with associated factors such as onset of admission (p = 0.044, GCS on admission (p= 0.003), severity of stroke (NIHSS) (p = 0.013), SAH severity (Hunt and Hess scale) (p=0.00), modified fisher scale (p=0.000), and coiling (p=0.001).The factor that most influenced the outcome was modified Fisher 3-4 (OR= 12,426, CI95% = 2,239 – 68,953) and non-coiling (OR: 12,2278, CI95% = 1,716 – 87,838). Discussion: There was a significant correlation between admission onset, GCS on admission, stroke severity (NIHSS score), modified Fisher scale, SAH severity (Hunt and Hess scale), and coiling, with the mortality of subarachnoid hemorrhage. Modified fisher scale and non-coiling were the most dominant factors that affected the mortality rate. Keywords: SAH, mortality, outcome
Costs of Stroke Treatment Under National Health Insurance at Dr. Mohammad Hoesin General Hospital Ramadhoni, Pinto Desti; Junaidi, Achmad; Octavinawaty, Lenny; Apriyono, Apriyono; Oktaviandi, Ardy
Journal of Neurointervention and Stroke Vol. 1 No. 1: MAY 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.11.1

Abstract

Highlight: Discrepancy in costs hospitalization Prevalence and risk factors ABSTRACT Introduction: Indonesia’s National Health Insurance/Jaminan Kesehatan Nasional (JKN) consider stroke a catastrophic disease due to its high treatment costs and healthcare system burden. Stroke patients need extended hospitalization, advanced procedures, and long-term rehabilitation, making it financially and socially burdensome. Endovascular procedures like mechanical thrombectomy and coiling improve clinical outcomes but are expensive. Objective: To outline the characteristics and hospitalization costs of stroke patients—both ischemic and hemorrhagic—covered by JKN at Dr. Mohammad Hoesin General Hospital, focusing on cost differences among conservative therapy, thrombolysis, mechanical thrombectomy, and coiling.  Method: A descriptive study with retrospective data collection was performed at a Type A hospital in South Sumatra, using patient records from January to April 2024. Result: Ischemic stroke was the most common type, with most patients aged 46-65 and male. Most patients stayed less than ten days on second-class wards. Conservative therapy was the most frequently used treatment. Hypertension and kidney disorders were the biggest risk factors and comorbidities. Hospital charges for mechanical thrombectomy and coiling exceeded INA-CBG (Indonesian Case Based Groups) reimbursement rates, highlighting a substantial gap between actual hospital costs and insurance coverage. For both stroke types, medication costs dominated total expenses. Conclusion: The significant gap actual hospital costs and INA-CBG reimbursement  rates for stroke treatments, especially for mechanical thrombectomy and coiling, may affect hospital policies on these interventions. To ensure long-term stroke management, revisions to reimbursement schemes should take into account the high costs associated with endovascular therapy.
Co-Authors Achmad Junaidi, Achmad Adwirianny, Ashita Hulwah Apriyono, Apriyono Desti Ramadhoni, Pinto Haswatty, Bayu Muhlisa, Safitri Oktaviandi, Ardy Puspita Ratnasari, Nurlia Ramadhoni, Pinto Desti Sugiharto, Henry