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All Journal Jurnal Respirasi (JR) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Hardian, Harris
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Health Professions Medicine & Pharmacology Public Health

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The Role of Macronutrients in Chronic Obstructive Pulmonary Disease: A Review Kristy, Anastasia; Hardian, Harris; Putra, Wayan Wahyu Semara; Yaniswari, Ni Made Dwita; Tania, Tryna
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.161-167

Abstract

The incidence of chronic obstructive pulmonary disease (COPD) is rising and is still regarded as one of the challenging medical issues. Regardless of the main relationship between tobacco smoking and toxic particle exposure with COPD, factors like nutritional status also play an important role in COPD progression and outcome, as the factor is an adaptable aspect. Malnutrition, sarcopenia, and obesity are nutritional problems that are often encountered in COPD patients. Macronutrients, namely carbohydrates, fat, and protein, support the adjunctive treatment options for COPD. The ideal dietary pattern includes low carbohydrates, medium fats preferably polyunsaturated fatty acids (PUFA), and high proteins to improve COPD symptoms, preserve muscle mass, and delay disease progression. High carbohydrate intake might also increase the respiratory quotient (RQ) which results in higher carbon dioxide (CO2) production and oxygen (O2) demand compared to fat and protein intake. Daily calorie intake should be adjusted to personal nutritional status. Higher calories in malnourished, sarcopenic patients and targeted weight loss in obese patients show improvements in lung function, frequency of exacerbations, and hospitalization rate. In obese individuals with COPD, however, maintaining a slightly higher body mass index (BMI) of 25-30 kg/m2 was associated with lower mortality. This literature review summarized the significant role of macronutrients in COPD patients and the practical approach to macronutrient intervention in individuals with different nutritional statuses.
Validation Study of the Cirrhosis Acute Gastrointestinal Bleeding Score as Predictor Mortality in Patients with Liver Cirrhosis and Upper Gastrointestinal Bleeding Mariadi, I Ketut; Hardian, Harris; Alamsyah, Ajib Zaim; Dewi, Ni Luh Putu Yunia; Dewi, Putu Itta Sandi Lesmana; Dewi, Ni Nyoman Gita Kharisma; Pamungkas, Kadek Mercu Narapati; Somayana, Gde; Wira Nugraha, Komang Agus; Sindhughosa, Dwijo Anargha; bin Abd Rahman, Mohamad Fadli
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 27, No 1 (2026): VOLUME 27, NUMBER 1, April, 2026
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/271202619-26

Abstract

Background: The Cirrhosis Acute Gastrointestinal Bleeding (CAGIB) score was developed as a mortality predictor by integrating a range of clinical and laboratory parameters. This research seeks to validate the efficacy of the CAGIB score in predicting in-hospital mortality among cirrhotic patients experiencing upper gastrointestinal bleeding (UGIB) at Ngoerah Hospital.Methods: This study is a prospective observational study employing a validation test approach. A total of 161 patients diagnosed with liver cirrhosis and upper gastrointestinal bleeding (UGIB) at Ngoerah Hospital were enrolled. Receiver Operating Characteristic (ROC) analysis was utilized to evaluate the prognostic capability of the CAGIB score in predicting mortality and to identify the optimal cutoff point. Validation was conducted by assessing the CAGIB score's sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV).Results: The analysis of the CAGIB score as a predictor of mortality yielded an area under the curve (AUC) value of 0.83, with the optimal cutoff point determined at ≥ -4.66, based on the point farthest from the diagonal line on the ROC curve. The 95% Confidence Interval (CI) ranged from 0.777 to 0.897. Validation testing of the CAGIB score as a predictor of in-hospital mortality demonstrated a sensitivity of 80.8%, specificity of 70.5%, PPV of 69.4%, and NPV of 81.6%.Conclusion: The CAGIB score has been demonstrated to serve as a valid predictor of mortality, exhibiting commendable sensitivity and specificity, along with satisfactory positive and negative predictive values. The optimal cutoff points appropriately reflect the demographic and clinical characteristics of the cirrhosis patient population with UGIB at Ngoerah Hospital
Co-Authors Alamsyah, Ajib Zaim bin Abd Rahman, Mohamad Fadli Dewi, Ni Luh Putu Yunia Dewi, Ni Nyoman Gita Kharisma Dewi, Putu Itta Sandi Lesmana Dwijo Anargha Sindhughosa, Dwijo Anargha Gde Somayana I Ketut Mariadi Kristy, Anastasia Pamungkas, Kadek Mercu Narapati Putra, Wayan Wahyu Semara Tania, Tryna Wira Nugraha, Komang Agus Yaniswari, Ni Made Dwita