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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Articles 1,063 Documents

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Prevalensi gen penyandi resisten Colistin mcr-1 pada isolat Klebsiella pneumoniae dan Escherichia coli Extended-Spectrum Beta-Lactamases (ESBL) di RSUP Sanglah, Bali tahun 2018 Gusti Ayu Dianti Violentina; Ni Nyoman Sri Budayanti; Ida Sri Iswari
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Antimicrobial resistance (AMR) is a serious threat to health, both human and animal health. Antibiotic resistance in the Enterobacteriaceae family, especially the bacteria Klebsiella pneumoniae and Escherichia coli, is a special focus because it is caused by pathogenic Gram-negative bacteria found in humans. This study aims to study the prevalence of Colistin mcr-1 resistant coding gene in Klebsiella pneumoniae and Escherichia coli Extended-Spectrum Beta-Lactamases (ESBL) isolates in Sanglah Hospital, Bali, in 2018.Methods: This study was conducted in 2 stages, namely examination by PCR and telephone by sequencing. This study's object was the bacteria Klebsiella pneumoniae and Escherichia coli ESBL in clinical isolates of the Clinical Microbiology Laboratory of Sanglah Hospital Denpasar-Bali. Data were analyzed using SPSS version 20 for Windows.Results: The results of this study indicate that the results of clinical examination of 300 isolates, most of the K. pneumoniae and E. coli specimens were found in urine (32.00%), followed by pus (24.00%), sputum (20.00%), blood (12.00%), and others (11.00%). Most of the K. pneumoniae infections were found in sputum (70.49%), pus (52.05%), and blood (70.27%) specimens. Of the 300 isolates obtained from the results, no isolates had the gene encoding colistin mcr-1 resistance in clinical isolates tested molecularly.Conclusion: From the results of this study, it can be concluded that the colistin mcr-1 resistance coding gene was not found in the tested isolates. Latar Belakang: Antimicrobial resistance (AMR) merupakan ancaman serius di dunia kesehatan baik kesehatan manusia maupun hewan. Resistensi antibiotika pada family Enterobacteriaceae khususnya bakteri Klebsiella pneumoniae dan Escherichia coli menjadi fokus khusus karena keduanya merupakan bakteri Gram negatif patogen yang sering ditemukan pada manusia. Penelitian ini bertujuan untuk mengevaluasi prevalensi gen penyandi resisten Colistin mcr-1 pada isolat Klebsiella pneumoniae dan Escherichia coli Extended-Spectrum Beta-Lactamases (ESBL) di RSUP Sanglah, Bali tahun 2018Metode: Penelitian ini dilakukan dalam 2 tahap yaitu identifikasi dengan PCR dan identifikasi dengan sekuensing. Objek dari penelitian ini ada bakteri Klebsiella pneumoniae dan Escherichia coli ESBL pada isolat klinik Laboratorium Mikrobiologi Klinik RSUP Sanglah Denpasar-Bali. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Hasil penelitian ini menunjukkan bahwa hasil pemeriksaan terhadap 300 isolat klinis sebagian besar specimen K. pneumoniae dan E. coli ditemukan pada urin (32,00%), diikuti dengan pus (24,00%), sputum (20,00%), darah (12,00%), dan lain-lain (11,00%). Sebagian besar infeksi K. pneumoniae ditemukan pada spesimen sputum (70,49%), pus (52,05%), dan darah (70,27%). Dari 300 isolat yang diperiksa didapatkan hasil bahwa tidak ada isolat yang memiliki gen penyandi resistensi colistin mcr-1 pada isolat klinik yang diujikan secara molekuler.Kesimpulan: Dari hasil penelitian ini dapat disimpulkan bahwa gen penyandi resisten colistin mcr-1 tidak ditemukan pada isolat yang diuji

Association between transformational leadership, organizational commitments, and application of Total Quality Management (TQM) to employee performance in Sanglah General Hospital, Bali, Indonesia Fery Dwiyanto; I Putu Ganda Wijaya; Putu Ayu Indrayathi
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Employee performance results from work achieved by an employee in quality and quantity in carrying out tasks in accordance with the responsibilities given. Good employee performance increases hospital customer satisfaction. This study aims to determine the relationship between transformational leadership, organizational commitment, and the application of Total Quality Management (TQM) with employee performance at Sanglah Central General Hospital.Methods: A cross-sectional study was conducted among 87 samples. Samples in each installation/unit that fulfilled inclusion criteria were selected using proportional random sampling. Data were analyzed using univariate, bivariate (chi-square), and multivariate (logistic regression) by SPSS version 20 for Windows.Results: Most employees perceived good in transformational leadership (67.8%), good organization commitment (55.2%), good application of TQM (75.9%), and good employee's performance (65.5%). The bivariate analysis shows a significant association between transformational leadership (p=0.001), organization commitment (p=0.001), and application of TQM (p=0.010) with employees' performance in Sanglah General Hospital. However, according to the multivariate analysis, a statistically significant association variable is organizational commitment (OR=547.96; 95% CI=4.922-613.673; p=0.001).Conclusion: Factors associated with the employee's performance in Sanglah Hospital are transformational leadership, organizational commitment, and TQM. Therefore, stakeholders in the hospital should consider the loyalty of employees in determining policies to improve service quality continuously.

Exogenous Rinolith: a case report I Putu Santhi Dewantara; Luh Made Ratnawati
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Rhinolith results from mineralized nasal foreign bodies. The time required for rhinolith formation is around 15 years and is usually diagnosed in the third decade of life. Most rhinoliths are asymptomatic or present with unspecific minimal symptoms. Symptoms of rhinolith include unilateral or bilateral foul nasal discharge, epistaxis, nasal obstruction, and halitosis. This case study aims to evaluate the recent management of exogenous rhinolith.Case Presentation: We present a case of unilateral rhinolith in an 11 years old boy with a history of inserting eraser fragment into the left nostril at the age of 5. The patient complained of recurrent epistaxis with foul nasal discharge from the left nasal cavity. Rhinolith was extracted under general anesthesia. The extraction performed using raspatorium and headlight. The rhinolith was firmly attached to the floor of the nasal cavity but can be removed in toto. The specimen was sent to the Pathology Department for histopathological examination. The result showed respiratory epithelium covering edematous stroma with a proliferative vessel and lymphoplasmacytic inflammatory cell infiltrationConclusion: Rhinolith is a rare condition with no or minimal symptoms. Management of rhinolith is extraction that can be performed under local or general anesthesia.

Hubungan antara Microvessel Density dan Lymphovascular Invasion dengan metastasis jauh pada pasien kanker payudara di RSUP Sanglah, Bali, Indonesia Trisye Septiawati; Ida Bagus Tjakra Wibawa Manuaba; Putu Anda Tusta Adiputra
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Breast cancer is the most common malignant tumor in Indonesia, with a relative frequency of 18,6%. Mortality in breast cancer most are caused by distant metastasis, which then causes multiple organ failure. To start a metastatic process requires new blood vessels (angiogenesis) and infiltration of the lymphatic system. Both can be assessed through microvessel density and lymphovascular invasion. This study aims to determine the relationship between Microvessel Density and Lymphovascular Invasion with metastasis in breast cancer patients at Sanglah General Hospital, Bali, Indonesia.Methods: A cross-sectional analytic study was conducted at the oncology surgical clinic from January 2018 - March 2019. Of the 62 biopsy samples were stained using hematoxylin-eosin and were observed by one pathologist. MVD cut-off points are taken by calculating the mean and standard deviation. Bivariate analysis using Chi-Square Test and multivariate analysis using logistic regression test was used for statistical analysis. Data were analyzed using SPSS version 23 for Windows.Results: From the results of a bivariate analysis, it was found that the high MVD is correlated with distant metastasis (P = 0.001) and positive LVI with metastasis (P = 0.003). There is a relationship between high MVD and tumor size (P = 0,000).Conclusion: Multivariate analysis confirmed that high MVD and positive LVI were statistically related to the occurrence of metastasis in breast cancer patients. Latar Belakang: Kanker payudara merupakan salah satu jenis kanker terbanyak di Indonesia dengan frekuensi relatif sebesar 18,6%. Kematian pada kanker payudara sebagian besar disebabkan oleh metastasis jauh yang kemudian menyebabkan kegagalan organ multipel. Untuk memulai suatu proses metastasis diperlukan pembentukan pembuluh darah baru (angiogenesis) dan juga infiltrasi sistem limfatik. Kedua hal tersebut bisa dinilai melalui microvessel density dan lymphovascular invasion. Penelitian ini bertujuan untuk mengetahui hubungan antara Microvessel Density dan Lymphovascular Invasion dengan metastasis jauh pada pasien kanker payudara di RSUP Sanglah, Bali, Indonesia.Metode: Penelitian potong lintang analitik dilakukan pada poliklinik bedah onkologi selama Januari 2018–Maret 2019. Dari 62 sampel biopsi dilakukan pembacaan microvessel dan lymphovascular invasion yang telah lebih dulu diberikan pewarnaan hematoxylin eosin oleh 1 patologi anatomi. Cut off point MVD diambil dengan cara menghitung mean dan standar deviasi. Analisis bivariat dengan Uji Chi-Square dan analisis multivariat dengan menggunakan uji regresi logistik digunakan untuk analisis statistik. Data dianalisis dengan SPSS versi 23 untuk Windows.Hasil: Dari hasil analisis bivariat didapatkan hubungan antara MVD yg tinggi dengan metastasis (P = 0,001) dan hubungan antara LVI positif dengan metastasis (P = 0,003). Terdapat hubungan antara MVD dengan ukuran tumor (P = 0,000).Simpulan: Analisis multivariat menegaskan bahwa MVD yang tinggi dan LVI positif berhubungan secara statistik dengan terjadinya metastasis pada pasien kanker payudara.

Positive calretinin stain with immunohistochemistry in a 49 year-old female with cardiac myxoma: A case report I Gusti Ayu Sri Mahendra Dewi
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Primary tumors of the heart are scarce. Cardiac myxoma is a primary benign heart tumor most often found with an incidence of 0.5-1.0 cases per million population per year and 90% diagnosed in the fourth to seventh decades of life, rarely found in children. Cardiac myxoma is three times more common in women than in men. These tumors are mostly found in the left atrium.Case description: Female, a 49-year-old patient, came with palpitations, shortness of breath, and weakness since the previous six months. On echocardiography, found a mass in the left atrium suspected of a left atrial myxoma. Surgery was performed, and the specimen was sent for histopathological examination. Macroscopically, the tumor mass shows an irregular shape, brownish color, and spongy consistency. Microscopic examination shows the tumor consisting of proliferation of spindle-shaped and stellate cells, with oval to round nuclei, eosinophilic cytoplasm, mostly scattered, some of which are arranged cord and nest, infiltrative between the myxoid stroma and partially surround small blood vessels to form a vasoformative ring. The specimen also contains the proliferation of blood vessels, extravasation of erythrocytes, and the distribution of inflammatory cells and hemosiderophages. The result of the immunohistochemical examination with calretinin was positive.Conclusion: This case was concluded as cardiac myxoma based on clinical features, echocardiography, macroscopic, routine histopathological, and immunohistochemical examinations.

Sistem skoring hematologi Rodwell sebagai metode diagnosis awal sepsis neonatorum di Rumah Sakit dengan fasilitas terbatas: sebuah tinjauan sistematis Anak Agung Ayu Karina Damayanti; Ketut Ngurah Alit Widiada
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Neonatal sepsis is a major cause of morbidity and mortality in neonates with an incidence in Indonesia at about 8.7 to 30.29%. Blood culture as the gold standard for diagnosis is not available in all health care centers. An easy, fast and inexpensive diagnostic method is needed to overcome these problems. The diagnostic method that can be used is the Rodwell hematology scoring system (HSS). It uses seven hematologic parameters obtained through a complete blood count and peripheral blood smears examination. This systematic review aims to evaluate Rodwell HSS as a method for early diagnosis of neonatal sepsis in hospitals with limited facilities.Methods: A systematic review of literature searching through the Cochrane Library, PubMed, and Google Scholar journal database was done by two reviewers. The inclusion criteria were studied about the diagnostic method for neonate's sepsis using Rodwell HSS and compared neonate's sepsis diagnostic method between Rodwell HSS and blood culture. The exclusion criteria were studies that were not published in English or Bahasa, not available in full text, and study with a case report, systematic review, or meta-analysis design.Result: The hematological scoring system has the same sensitivity as its specificity. Sensitivity range is 80-100%, specificity 60.3-90%, PPV 26-73% and NPV 92.1-100%. A score of > 4 has an AUC value of 90.2%, which shows that this diagnostic test's accuracy is excellent.Conclusion: The hematological scoring system with a score of > 4 gives the most rational and reliable results for the early diagnosis of neonatal sepsis. Due to its high sensitivity, specificity, and using simple examination, making these criteria suitable to use as a method for early diagnosis of neonatal sepsis, especially in limited health facilities hospital. Latar belakang: Sepsis neonatorum merupakan penyebab utama morbiditas dan mortalitas pada neonatus dengan angka prevalensi di Indonesia 8,7 hingga 30,29%. Pemeriksaan baku emas untuk penegakkan diagnosis yaitu kultur darah, tidak tersedia di seluruh sentra layanan kesehatan. Sebuah metode diagnostik yang mudah, cepat dan murah diperlukan untuk mengatasi permasalahan tersebut yakni dengan sistem skoring hematologi (SSH) Rodwell. Tujuan tinjauan sistematis ini adalah mengevaluasi peran SSH Rodwell sebagai metode diagnosis dini sepsis neonatorum di rumah sakit dengan fasilitas terbatas.Metode: Tinjauan sistematis berupa penelusuran literatur dilakukan oleh dua orang peneliti melalui database jurnal Cochrane Library, PubMed dan Google Scholar menggunakan operator Boolean. Kriteria inklusinya adalah studi mengenai metode diagnosis sepsis pada neonatus menggunakan SSH Rodwell dan membandingkan antara SSH Rodwell dengan kultur darah. Sedangkan kriteria eksklusinya studi yang terpublikasi tidak dalam bahasa Inggris atau Indonesia, tidak tersedia secara full-text dan desain studi berupa laporan kasus, tinjauan sistematis atau meta analisis.Hasil: SSH Rodwell memiliki sensitivitas yang sama baiknya dengan spesifitasnya. Sensitivitas berada dalam rentang 80-100%, spesifisitas 60,3-90%, PPV 26-73% dan NPV 92,1-100%. Skor >4 memberikan nilai AUC 90,2% menunjukkan akurasi test diagnostik ini sangat baik.Kesimpulan. SSH Rodwell dengan skor >4 memberikan hasil yang paling rasional dan reliabel untuk diagnosis awal sepsis pada neonatus. Penggunaan parameter yang sederhana menjadikan pemeriksaan ini cocok diaplikasikan pada rumah sakit dengan fasilitas kesehatan terbatas.

Aspek klinis dan tatalaksana gagal jantung pada anak: tinjauan pustaka Herick Alvenus Willim; Cristianto Cristianto; Danayu Sanni Prahasti; Harie Cipta; Andi Anita Utami
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Heart failure in children is a serious health problem and associated with high morbidity and mortality. The causes and clinical manifestations of heart failure in children differ significantly with heart failure in adults. Therefore, a comprehensive understanding of heart failure in children is needed. This literature review aims to provide a review of clinical aspects and treatment of heart failure in children.Methods: This literature review included 47 relevant literature on clinical aspects, management of heart failure, and children. Different data sources or manual literature studies were used to search for articles related to literature topics.Results: The main causes of heart failure in children are congenital heart disease and cardiomyopathy. Diagnostic approach of heart failure in children is based on clinical features combined with supporting examination. The principal treatment of heart failure in children includes identification and elimination of precipitating factors, correction of underlying causes, and management of pulmonary or systemic congestion.Conclusion: Heart failure is a complex clinical syndrome that results from structural or functional disorders of the filling or ejection of blood from the ventricles of the heart where the clinical manifestations and management of heart failure in children are specific. Latar Belakang: Gagal jantung pada anak merupakan masalah kesehatan serius dan berhubungan dengan morbiditas dan mortalitas yang tinggi. Penyebab dan manifestasi klinis gagal jantung pada anak berbeda signifikan dengan gagal jantung pada orang dewasa. Oleh karena itu, dibutuhkan pemahaman komprehensif tentang gagal jantung pada anak. Tinjauan pustaka ini bertujuan untuk memberikan ulasan mengenai aspek klinis dan tatalaksana gagal jantung pada anak.Metode: Tinjauan pustaka ini melibatkan 47 literatur yang relevan tentang aspek klinis, tatalaksana gagal jantung, dan anak. Sumber data yang berbeda atau metode pencarian literatur manual digunakan untuk mencari artikel yang berkaitan dengan topik literatur.Results: Penyebab utama gagal jantung pada anak adalah penyakit jantung bawaan dan kardiomiopati. Pendekatan diagnosis gagal jantung pada anak berdasarkan gambaran klinis yang dikombinasikan dengan pemeriksaan penunjang. Prinsip tatalaksana gagal jantung pada anak meliputi identifikasi dan eliminasi faktor presipitasi, koreksi penyebab yang mendasari, serta penanganan kongesti pulmonal atau sistemik.Kesimpulan: Gagal jantung adalah suatu sindrom klinis kompleks yang terjadi akibat gangguan struktural atau fungsional dari pengisian atau ejeksi darah dari ventrikel jantung dimana manifestasi klinis dan tatalaksana gagal jantung pada anak bersifat khusus.

Hubungan antara status nutrisi dan kualitas hidup pada pasien penyakit ginjal kronik yang menjalani hemodialisis di Rumah Sakit Umum Daerah (RSUD) Wangaya, Denpasar, Bali Lindia Prabhaswari; I Gede Sadu Pratama Werdi; I Wayan Sunaka
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Quality of life is an important consideration in managing patients with chronic kidney disease (CKD). A number of factors are known to influence Quality of life in a patient with CKD, one of them is nutrition. In this study, we aimed to determine the relationship between nutritional status and Quality of life in CKD patients undergoing hemodialysis. Methods: A cross-sectional analytic study was conducted at Wangaya Regional Hospital, Denpasar, from August to September 2020. Fifty-seven hemodialysis patients were enrolled in this study. Malnutrition Inflammation Score (MIS) and Kidney Disease Quality of Life Short Form-36 (KDQoL SF-36) questionnaires were used to assess nutritional status and Quality of life. Data were analyzed using SPSS software version 20 for Windows, where a p-value of less than 0,05 was considered statistically significant.Results: Of the total 57 subjects, the mean age was 50.12±13.1 years, with 68.4% male. The mean MIS score was 3.05±1.8, while the mean KDQoL score was 73.7±13.4. Pearson test found a significantly strong negative correlation between nutritional status and Quality of life (r=-0,784; p<0,001).Conclusion: There is a significant relationship between nutritional status and Quality of life in chronic kidney disease patients undergoing hemodialysis in Wangaya Regional Hospital, Denpasar. Latar Belakang: Kualitas hidup merupakan hal penting yang harus diperhatikan dalam menangani pasien penyakit ginjal kronik (PGK). Salah satu faktor yang memengaruhi kualitas hidup pasien PGK adalah nutrisi. Penelitian ini bertujuan untuk mengevaluasi hubungan antara status nutrisi dan kualitas hidup pada pasien PGK yang menjalani hemodialisis rutin.Metode: Penelitian ini merupakan penelitian analitik observasional yang dilakukan di RSUD Wangaya Denpasar pada bulan Agustus-September 2020. Subjek penelitian adalah 67 pasien PGK yang menjalani hemodialisis rutin. Instrumen penelitian berupa kuesioner malnutrition inflammation score (MIS) dan kidney disease quality of life short form-36 (KDQoL SF-36). Data yang terkumpul selanjutnya dianalisis dengan menggunakan perangkat lunak SPSS versi 20 untuk Windows dimana nilai p<0,05 dianggap signifikan secara statistik.Hasil: Rerata usia subjek adalah 50,12±13,1 tahun, dengan 68,4% subjek berjenis kelamin laki-laki. Rerata skor MIS subjek adalah 3,05±1,8, sedangkan rerata skor KDQoL adalah 73,7±13,4. Uji korelasi pearson menunjukkan korelasi negatif kuat antara skor MIS dan skor KDQoL (nilai r=-0,784 dan nilai p<0,001). Simpulan: Terdapat hubungan yang signifikan antara status nutrisi dan kualitas hidup pada pasien penyakit ginjal kronik yang menjalani hemodialisis rutin di RSUD Wangaya, Denpasar.

Relationship Between Procalcitonin Serum Level and Septic Patient Mortality in Dr. Saiful Anwar General Hospital, Malang Agustin Iskandar; Deasy Ayuningtyas Tandio; Yeni Ayu Prihastuti
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Procalcitonin is more frequently analyzed for sepsis diagnosis. Procalcitonin shows a tendency to increase as sepsis worsens. However, published studies investigating the correlation between procalcitonin and mortality in an adult patient with sepsis in Indonesia were lacking. This research aims to know the relationship between procalcitonin and mortality in sepsis.Methods: A prospective cohort study was conducted in Dr. Saiful Anwar Public General Hospital, Malang, Indonesia from March to November 2018. During the study period, patients diagnosed with sepsis according to JAMA Sepsis-3 were tested for procalcitonin using Cobas e411 ECLIA method. The demographic and mortality data were acquired from the patients’ medical record. The statistical analysis was done with SPSS v.23, ? = 0.05.Results: From a total of 69 subjects, 43 did not survive (62.32%). The procalcitonin serum level is significantly higher in the non-survivors than the survivors (37.77 ng/mL vs. 3.07 ng/mL, p=0.016). The Spearman’s rank correlation test showed r=0.293 (p=0.015). Using a cutoff point of 2 ng/mL, the relative risk is 2.77 (0.950-8.078).Conclusion: There is a statistically significant weak relationship between procalcitonin and mortality, in which patients with procalcitonin equal or more than 2 ng/mL were 2.77 times more likely not to survive sepsis.

Evaluasi derajat delirium sebagai prediktor mortalitas pasien usia lanjut dengan delirium yang dirawat di RSUP Sanglah, Bali, Indonesia Dian Pritasari Jeger; Yosef Samon Sugi; I Gusti Putu Suka Aryana; RA Tuty Kuswardhani; I Nyoman Astika; Ida Bagus Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Delirium is an acute attention and cognitive disorder that occurs in elderly patients. The disorder is usually very serious, often goes unrecognized, and is usually fatal. Diagnosis requires a complete cognitive assessment and a history of acute symptoms. Despite the management of the cause, patients with delirium do not always recover. The aim of this study was to determine the correlation between the degree of delirium and the incidence of death in geriatric patients who were admitted to Sanglah General Hospital.Methods: A retrospective cohort study was conducted during November 2014-February 2015 of consecutive patients with delirium aged over 60 years. The degree of delirium was measured by the Memorial Delirium Assessment Scale (MDAS) and Charlson's-Age Comorbidity Index (CACI). These patients were followed periodically and then a bad outcome was determined, namely death while being treated. The association between the severity of delirium and clinical outcome was evaluated using the Pearson test. The results are said to be significant if the p value <0.05 on SPSS version 21 for Windows.Results: The prevalence of delirium in Sanglah General Hospital was mild delirium (48.4%), moderate delirium (28.1%), and severe delirium (23.4%). There was a significant difference in the prevalence of the degree of delirium based on age (p <0.05), but not on gender (p = 0.752). There was a significant difference in the incidence of death based on age (p = 0.045) and degree of delirium (p = 0.01). There was a moderate positive correlation between the degree of delirium and the incidence of death (p = 0.02; r = 0.373).Conclusion: There is a significant relationship between the degree of delirium and the incidence of death in geriatric patients hospitalized in Sanglah General Hospital. Latar belakang: Delirium merupakan gangguan perhatian dan kognitif akut yang terjadi pada pasien usia tua. Gangguan tersebut biasanya sangat serius, sering tidak dikenali, dan biasanya sangat fatal. Penegakan diagnosis memerlukan penilaian kognitif yang lengkap dan riwayat adanya gejala yang timbul secara akut. Meskipun diberikan penatalaksanaan terhadap penyebabnya, pasien dengan delirium tidak selalu pulih. Tujuan dari penelitian ini adalah untuk menentukan korelasi antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.Metode: Penelitian kohort retrospektif dilakukan selama bulan November 2014-Februari 2015 terhadap pasien dengan delirium yang berusia di atas 60 tahun secara konsekutif. Derajat delirium diukur dengan Memorial Delirium Assesment Scale (MDAS) dan Charlson’s-Age Comorbidity Index (CACI). Pasien tersebut diikuti secara berkala kemudian ditentukan luaran yang buruk yaitu kematian saat dirawat. Hubungan antara derajat keparahan delirium dengan luaran klinis dievaluasi menggunakan uji Pearson. Hasil dikatakan bermakna apabila nilai p<0.05 pada SPSS versi 21 untuk Windows.Hasil: Prevalensi delirium di RSUP Sanglah yakni delirium ringan (48,4%), delirium sedang (28,1%), dan delirium berat (23,4%). Terdapat perbedaan bermakna prevalensi derajat delirium berdasarkan umur (p<0,05), namun tidak pada jenis kelamin (p=0,752). Terdapat perbedaan bermakna pada insiden kematian berdasarkan umur (p=0,045) dan derajat delirium (p=0,01). Terdapat korelasi positif sedang antara derajat delirium dengan insiden kematian (p=0,02; r=0,373).Kesimpulan: Terdapat hubungan yang signifikan antara derajat delirium dengan insiden kematian pada pasien geriatri yang dirawat di RSUP Sanglah.

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