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Mortality Prediction Model in Sepsis Emergency: Combination of Biomarkers and Clinical Parameters at Grandmed Hospital Lubuk Pakam in 2023 Arif Sujatmiko
Medistra Medical Journal (MMJ) Vol 2 No 2 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/7c6yq649

Abstract

Background: Sepsis is a complex clinical syndrome and a life-threatening medical emergency with a high global mortality rate. Worldwide, sepsis accounts for an estimated 11 million deaths annually, equivalent to nearly 20% of all global deaths. In Indonesia, mortality rates in intensive care units remain between 30–60%. One of the major challenges in sepsis management is delayed diagnosis and the difficulty in identifying patients at high risk of death. Conventional prognostic tools such as SOFA or qSOFA scores are widely used, but their predictive accuracy is limited. Biomarkers such as procalcitonin (PCT), C-reactive protein (CRP), and lactate have been shown to provide diagnostic and prognostic information, yet their utility as single predictors remains insufficient. Objective: This study aimed to develop a mortality prediction model for septic patients by combining biomarkers (PCT, CRP, lactate) and clinical parameters (SOFA score) at RS Grandmed Lubuk Pakam in 2023. Methods: An observational analytic study with a prospective cohort design was conducted on 110 adult patients diagnosed with sepsis based on Sepsis-3 criteria. Demographic, clinical, and biomarker data were collected within the first 24 hours of admission. Statistical analysis included bivariate testing and multivariate logistic regression. Model performance was assessed using ROC curves, AUC, sensitivity, specificity, PPV, and NPV. Results: The overall sepsis mortality rate was 59.1%. Multivariate analysis identified SOFA ≥9 (OR=3.74; p=0.006), PCT ≥10 ng/mL (OR=2.91; p=0.028), and lactate ≥4 mmol/L (OR=4.56; p=0.001) as independent predictors of mortality. The combined model of SOFA, PCT, and lactate demonstrated the highest accuracy with an AUC of 0.91, sensitivity 85%, and specificity 83%, outperforming any single predictor. Conclusion: The integration of SOFA score, procalcitonin, and lactate substantially improves the predictive accuracy of mortality in septic patients compared to conventional approaches. This model may serve as a valuable clinical decision support tool for early risk stratification, although external validation in larger cohorts is required before routine clinical implementation.
The Role of an Integrated Administration System in Reducing Patient Waiting Times in the Emergency Department at Grandmed Hospital Lubuk Pakam in 2025 Rahmad Ramadhan Ritonga; Arif Sujatmiko; Putri Sari Maharani
JURNAL KESMAS DAN GIZI (JKG) Vol. 8 No. 1 (2025): Jurnal Kesmas dan Gizi (JKG)
Publisher : Fakultas Kesehatan Masyarakat Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/fnrvh047

Abstract

The Emergency Department (ED) is a vital hospital service that is required to provide fast, accurate, and efficient care. However, administrative processes that are not fully integrated often prolong patient waiting times. This study aims to analyze the role of integrated administrative systems in reducing patient waiting times at the ED of Grandmed Hospital Lubuk Pakam in 2025. A quantitative research design with a cross-sectional approach was applied, involving 100 patients and 20 administrative staff selected through purposive sampling. Data were collected through patient waiting time observations, staff perception questionnaires, and hospital documents. The results showed that most staff assessed the integrated administrative system as effective (75%). The average patient waiting time decreased from 7 minutes to 4 minutes after the system was implemented, meeting the Indonesian Ministry of Health’s service standard (≤5 minutes). Spearman correlation analysis revealed a significant relationship between administrative system effectiveness and patient waiting time (p = 0.002; r = –0.521). Simple linear regression further indicated that the effectiveness of the administrative system significantly contributed to reducing patient waiting times, with an effect size of 37% (R² = 0.37). In conclusion, the integrated administrative system plays an important role in improving the efficiency of ED services by reducing patient waiting times, and its continuous optimization is strongly recommended.