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eJournal Kedokteran Indonesia
Published by Universitas Indonesia
ISSN : 23381426     EISSN : 23386037     DOI : http://doi.org/10.23886/ejki
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
eJournal Kedokteran Indonesia (eJKI) is a general medical journal, published quadrimester (April, August, December) by Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. eJKI aims to published the manuscript of students (Bachelor of Medicine (S.Ked), study Program of Medical Profession, magister/specialist, doctoral, and fellow). The journal is a general medical journal that covering all areas of biomedical science, basic medical science, clinical science, medical technology, and medical education. The journal accepts editorial, research article, reviews, evidence-based case report, and also interesting case reports/case study. This work was supported by Faculty of Medicine, Universitas Indonesia.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 100 Documents
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Hubungan Faktor Sosiodemografis Korban Kekerasan Seksual Anak dengan Kedatangan ke Poliklinik Stres Pasca-trauma RSCM, 2017-2020 Andika Widianti; Fransiska Kaligis; Tjhin Wiguna; Raden Irawati Ismail
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.162.121-8

Abstract

Kedatangan korban kekerasan seksual anak ke layanan kesehatan mental cukup rendah. Keputusan mengakses layanan kesehatan mental dipengaruhi faktor sosiodemografis. Penelitian bertujuan mendapatkan gambaran faktor sosiodemografis korban kekerasan seksual anak dan hubungannya dengan kedatangan ke Poliklinik Stres Pasca Trauma (PSPT) Anak dan Remaja RSCM setelah pemeriksaan awal di Pusat Krisis Terpadu (PKT) RSCM. Studi potong lintang ini melibatkan 90 pasien yang datang ke PKT RSCM pada bulan Februari 2017 – Desember 2020. Kedatangan ke PSPT ditelusuri dari electronic health record. Terdapat 20 sampel (22,22%) korban yang datang, sebagian besar berusia 12-18 tahun (55%), perempuan (95%), dan tidak memiliki riwayat gangguan mental (70%). Pelaku rawat sebagian besar berusia 39-48 tahun (50%), menikah (80%), karyawan swasta (70%), lulusan SMA/SMK (45%), tidak memiliki riwayat gangguan mental (85%), mempunyai ≥ 3 anak (45%), suku Jawa (35%), pendapatan ≥ Rp 4.597.078 (70%), dan menggunakan pembiayaan umum (65%). Riwayat gangguan mental pada anak (p<0,001) dan pelaku rawat (p=0,010) berhubungan dengan kedatangan ke PSPT. Disimpulkan faktor sosiodemografi, yaitu riwayat gangguan mental pada anak dan pelaku rawat berhubungan dengan kedatangan ke PSPT. Kata kunci: anak, kedatangan ke layanan kesehatan mental, kekerasan seksual.   Child Sexual Abuse Victims Sociodemographic Profile Associated with Attendance to Post Traumatic Stress Recovery Outpatient Clinic Cipto Mangunkusumo Hospital: 2017-2020 Abstract Child sexual abuse victim attendance to mental health services is quite low. Decision to access mental health services is influenced by sociodemographic factors. The aim of this study is to obtain child sexual abuse victim sociodemographic profile and their association with attendance to Cipto Mangunkusumo Hospital’s Child and Adolescent Post Traumatic Stress Recovery Outpatient Clinic after initial assessment in Cipto Mangunkusumo Hospital’s Integrated Crisis Center. This cross-sectional study involving 90 patients who came to Cipto Mangunkusumo Hospital’s Integrated Crisis Center in February 2017 – December 2020. Attendances to Cipto Mangunkusumo Hospital’s Post Traumatic Stress Recovery Outpatient Clinic were traced from electronic health record. There were 20 samples (22.22%) who came, majority were 12-18 years old (55%), female (95%), and did not have mental disorders (70%). Most of caregivers were 39-48 years old (50%), married (80%), private employees (70%), high school graduate (45%), do not have mental disorders (85%), have ≥ 3 children (45%), Javanese (35%), income > IDR 4,597,078 (70%), and use out of pocket financing (65%). Mental disorders history in children (p<0,001) and caregivers (p=0.010) had a significant relationship with attendance at Cipto Mangunkusumo Hospital’s Child and Adolescent Post Traumatic Stress Recovery Outpatient Clinic. Concluded that sociodemographic factor, that is mental disorders history in children and caregivers had association with attendance to Cipto Mangunkusumo Hospital’s Child and Adolescent Post Traumatic Stress Recovery Outpatient Clinic. Keywords: attendance to mental health services, children, sexual abuse.
Factors Affecting Adverse Events Following SARS-CoV-2 Vaccine among Indonesian Ear, Nose, and Throat Specialist, and Residences Susyana Tamin; Jenny Bashiruddin; Indra Zachreini; Harim Priyono; Ika Dewi Mayangsari; Respati Ranakusuma; Natasha Supartono; Khoirul Anam; Anggina Diksita; Yussy Afriana Dewi; Sagung Rai Indrasari; Nyilo Purnami; Tengku Siti Hajar Haryuna; Juliandi Harahap; Eka Savitri; Tjandra Manukbua
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.165.129-37

Abstract

This study’s objectives were to investigate factors affecting the adverse events of the COVID-19 vaccine in Indonesia among health care workers and compare adverse events following SARS-CoV-2 vaccine using CoronaVac as the first and second dose and Moderna used as the booster third dose. A cross-sectional study was conducted using the Self-reporting Online Survey Platform (Google Form) from August to October 2021. Subjects included in the study were ENT specialists and residents all over Indonesia who had been vaccinated with both doses of CoronaVac COVID-19 vaccine and Moderna COVID-19 vaccine as a booster dose. Among a total of 1394 participants, 51.2% and 43.7% of subjects experienced adverse events following the first and second dose of the CoronaVac vaccine. Adverse events are significantly higher following the third dose of Moderna vaccine (95.3%) with p-value <0.001, odds ratio (OR) 26.63 (95% CI 19.87-35.7). Adverse events following the CoronaVac vaccine were significantly higher in females and individuals with comorbidities in the first dose (p=0.002 and p=0.04), and the second dose (p=0.008 and p=0.042). Adverse events following the Moderna vaccine were significantly higher in females (p=0.01) and lower in individuals ≥40 years of age (p=0.017). Comorbidity status did not affect adverse events following the Moderna vaccine. Keywords: adverse events, SARS-CoV-2, COVID-19, vaccine, otorhinolaryngology.   Faktor yang Mempengaruhi Efek Samping Vaksin SARS-CoV-2 terhadap Dokter Spesialis dan Residen Telinga, Hidung, dan Tenggorok di Indonesia Abstrak Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi efek samping vaksin COVID-19 di Indonesia pada petugas kesehatan dan membandingkan efek samping setelah vaksin SARS-CoV-2 menggunakan CoronaVac sebagai dosis pertama dan kedua dan Moderna sebagai booster dosis ketiga. Studi potong lintang dilakukan dengan menggunakan self-reporting survei online (Google Form) dari Agustus-Oktober 2021. Subjek yang termasuk dalam penelitian adalah dokter residen dan spesialis THT di Indonesia yang telah divaksinasi dengan kedua dosis vaksin CoronaVac COVID-19 dan vaksin Moderna COVID-19 sebagai dosis tambahan. Dari total 1394 peserta, 51,2% dan 43,7% subjek mengalami efek samping setelah dosis pertama dan kedua vaksin CoronaVac. Efek samping secara signifikan lebih tinggi setelah dosis ketiga vaksin Moderna (95,3%) dengan p-value <0,001, rasio odds (OR) 26,63 (95% CI 19,87-35,7). Efek samping setelah vaksin CoronaVac secara signifikan lebih tinggi pada wanita dan individu dengan penyakit penyerta pada dosis pertama (p=0,002 dan p=0,04), dan dosis kedua (p=0,008 dan p=0,042). Efek samping setelah vaksin Moderna secara signifikan lebih tinggi pada wanita (p=0,01), dan lebih rendah pada individu ≥ 40 tahun (p=0,017). Status komorbiditas tidak mempengaruhi efek samping setelah vaksin Moderna. Kata kunci: efek samping, SARS-CoV-2, COVID-19, vaksin, otorinolaringologi.
Profil Aberasi Kromosom Pasien Malformasi Kongenital Multipel Non-Sindromik Yulia Ariani Aswin; Rizky Abi Rachmadi
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.179.114-20

Abstract

Malformasi kongenital multipel (MKM) non-sindromik merupakan penyakit neonatal dengan mortalitas tinggi, menurunkan kualitas hidup anak dan mahalnya biaya perawatan. Untuk mendiagnosis MKM-non-sindromik diperlukan analisis kromosom secara akurat dengan biaya terjangkau yaitu metode G-banding, namun detection rate belum diketahui. Penelitian bertujuan untuk mengetahui proporsi MKM non-sindromik yang dapat didiagnosis dengan metode G-banding. Penelitian ini menggunakan desain potong lintang dengan subjek semua pasien yang datang ke laboratorium sitogenetik Departemen Biologi FKUI pada Juli 2014 sampai dengan Desember 2017. Pasien dilakukan pemeriksaan fisis kemudian dibandingkan dengan basis data Online Mendelian Inheritance in Man (OMIM) untuk menyeleksi pasien MKM sindromik dan non-sindromik. Sebanyak 34 dari 83 subjek (41%) dapat ditegakkan diagnosis klinis menggunakan database fenotip. Sebanyak 49 pasien memenuhi kriteria penelitian kemudian dilakukan analisis kromosom dengan metode G-banding. Terdapat 17 (34,7%) subyek yang menunjukkan aberasi kromosom. Tiga fenotip tersering pada subjek adalah hambatan pertumbuhan, mikrosefali, dan penyakit jantung bawaan. Disimpulkan metode G-banding sebagai pemeriksaan skrining awal pada MKM berperan penting dalam mendiagnosis penyebab genetik. Kata kunci: MKM non-sindromik, basis data fenotip, Indonesia, G-banding.   Chromosome Aberration Profiles in Patients with Non-Syndromic Multiple Congenital Malformation Abstract Non-syndromic multiple congenital malformations (MCM) remains a significant problem in Indonesia as it causes high mortality and morbidity rate in neonates and infants as well as a significant financial burden for families in caring for patients with non-syndromic MCM. Genetics is the major cause of non-syndromic MCM, and more than 50% is caused by chromosomal abnormalities. Considering the condition in Indonesia, where most families have a low socioeconomic background and where there are limited molecular genetics laboratory facilities, this research aims to study the proportion of non-syndromic MCM that can be detected using G-banding and describe chromosome aberration profiles in non-syndromic MCM patients. The Online Mendelian Inheritance in Man (OMIM) was used to differentiate non-syndromic and syndromic MCM in 83 recruited MCM patients. Thirtyfour patients (41%) were diagnosed using a phenotype database based on clinical signs. The three most common phenotypes were growth failure, microcephaly, and congenital heart diseases. Forty-nine patients were classified with non-syndromic MCM after filtering with OMIM and underwent G-banding. Seventeen out of 49 non-syndromic MCM patients (34.7%) had chromosome aberration after G-banding. This indicates that G-banding remains an effective first-line screening tool for non-syndromic MCM in Indonesia. Keywords: non-syndromic multiple congenital malformation, phenotype database, G-banding, Indonesia.
In-Hospital Major Adverse Cardiac Events Factor Predictors on ST-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention at dr. Cipto Mangunkusumo General Hospital Sally Aman Nasution; Hendra Perkasa; Eka Ginanjar; Ikhwan Rinaldi
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.193.107-13

Abstract

Major Adverse Cardiac Events (MACE) are the main causes to increase mortality in ST-Elevation Myocardial Infarction (STEMI) patients who undergo Primary Percutaneous Coronary Intervention (PPCI). In-hospital MACE inducing factor predictors identification is expected to enhance STEMI patients’ care and outcome. This study aims to identify in-hospital MACE factor predictors in STEMI patients with PPCI treatment at RSCM. Retrospective cohort study by tracing medical records on patients with PPCI treatment at RSCM from January 2015 - March 2020. The chi-squared bivariate analysis concluded between predictor factors; age, smoking, hypertension, diabetic Mellitus, chronic kidney disease, time-to-treatment, Killip class, left ventricle ejection fraction (LVEF) and LDL cholesterol level. Logistic regression is used in multivariate and prediction model analysis on variables with p<0,25 in bivariate analysis. This study involves 291 patient subjects. The occurrence of MACE is 43.3% on patients age > 60 years (29,6%), smoking (61,2%), hypertension (50,9%), diabetes mellitus (36,1%), chronic kidney disease (6,2%), Killip class II-IV (32,2%), LVEF > 50% (57%) dan cholesterol LDL level > 100 mg/dl (79,4%). Median time-to-treatment is 528 (379-730) minutes. Age, Killip class, and LVEF influences in-hospital MACE during PPCI with OR (95% CI) consecutively are 2,15 (1,22-3,79), 4,34 (2,49-7,56) and 2,88 (1,72-4,82). MACE prediction model in this study produces area under curve (AUC) 0,729 (95% CI 0,67-0,78). In-hospital MACE on STEMI patients after PPCI occurrence is 43.3%, influenced by age, Killip class, and LVEF. Keywords: major adverse cardiac events, primary percutaneous coronary intervention, myocardial infarction.   Faktor Prediktor Major Adverse Cardiac Events Selama Perawatan pada Pasien ST-Elevasi Miokard Infark yang Menjalani Intervensi Koroner Perkutan Primer di RSUPN dr. Cipto Mangunkusumo Abstrak Major Adverse Cardiac Events (MACE) merupakan penyebab utama meningkatnya mortalitas pada pasien STElevasi Miokard Infark (STEMI) yang menjalani intervensi koroner perkutan primer (IKPP). Identifikasi faktor prediktor yang mempengaruhi terjadinya MACE selama perawatan diharapkan dapat meningkatkan perawatan dan luaran klinis dari pasien STEMI. Penelitian ini bertujuan untuk mengetahui faktor prediktor MACE selama perawatan pada pasien STEMI yang dilakukan IKPP di RSCM. Studi kohort retrospektif dengan menelusuri rekam medis pasien yang menjalani IKPP di RSCM periode Januari 2015-Maret 2020. Dilakukan analisa bivariat antara faktor prediktor usia, status merokok, hipertensi, diabetes mellitus, penyakit ginjal kronik, time-to-treatment, kelas killip, fraksi ejeksi ventrikel kiri (FEVK) dan kadar kolesterol LDL dengan kejadian MACE selama perawatan pada pasien STEMI yang menjalani IKPP, menggunakan metode Chi-square. Analisa multivariat dan analisa model prediksi dilakukan dengan metode regresi logistik terhadap variabel dengan nilai p= <0,25 pada analisa bivariat.Didapatkan subyek sebanyak 291 pasien untuk diteliti. Major Adverse Cardiac Events selama perawatan didapatkan sebesar 43,3% dengan usia >60 tahun (29,6%), status merokok (61,2%), hipertensi (50,9%), diabetes mellitus (36.1%), penyakit ginjal kronik (6,2%), kelas Killip II-IV (32,2%), FEVK > 50% (57%) dan kadar kolesterol LDL > 100 mg/dl (79,4%). Median timeto-treatment didapatkan sebesar 528 (379-730) menit. Usia, kelas killip dan FEVK mempengaruhi kejadian MACE selama perawatan dengan OR (IK 95%) masing-masing 2,15 (1,22-3,79), 4,34 (2,49-7,56) dan 2,88 (1,72-4,82). Model prediksi MACE selama perawatan pada pasien STEMI yang menjalani IKPP memiliki nilai area under curve (AUC) 0,729 (IK 95% 0,67-0,78). Major Adverse Cardiac Events (MACE) selama perawatan Kata kunci: major adverse cardiac events, intervensi koroner perkutan primer, infark miokard.
One Health, Kesehatan Satu Bersama Tjandra Y Aditama
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.207.90-1

Abstract

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Successful Management of Complex Congenital Cataract and Its Complication: A Case Report: Keberhasilan Tatalaksana Katarak Kongenital Kompleks dan Komplikasinya: Sebuah Laporan Kasus Dian Estu Yulia; Yulika Harniza; Lia Amanda
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.58.265-70

Abstract

Management of cataract and its complication after surgery in a child with complex congenital cataract where accompanied by other ocular abnormality can pose a great surgical challenge. This case report described a case of an 18-year-old girl with slowly decreasing vision after undergoing surgery charity on the right eye (RE) around 4 months ago due to cataract which she had since birth. Best corrected visual acuity (BCVA) preoperatively of the RE and LE was 6/60 and 0,5/60 respectively. Ocular assessment was pseudophakia with Posterior Capsular Opacity (PCO) on the RE and cataract on the left eye (LE) accompanied by microcornea, nystagmus and coloboma of iris and retina on both eyes. Secondary posterior capsulotomy surgery was done on the RE and cataract extraction, Primary Posterior Capsulotomy (PPC) on the LE with Anterior Vitrectomy (AV) on both eyes. Last follow-up postoperatively showed a significant improvement of uncorrected visual acuity on her RE from 0.5/60 preoperatively to 6/30, meanwhile only subjective improvement of VA was found on her LE. This case can achieve visual improvement with promptly surgical treatment without complication and routine monitoring still needs to be done.
Chronic Kidney Disease in Hospital Cooks Rita Ingewaty Wijaya; Dewi Sumaryani Soemarko
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.125.271-5

Abstract

Chronic kidney disease is still a concern for health problems in Indonesia. Complications of chronic kidney disease include hypertension, cardiovascular disease, decreased kidney function to the end stage and even death. One of the potential dangers is heat, which not only causes the risk of kidney and cardiovascular health problems but it can also worsen the condition of the disease. Workplaces such as hospital kitchens have a risk of heat exposure. This shows the importance of fit-to-work assessment based on occupational medicine management. A 55-year-old cook worker with stage IV chronic kidney disease came to the hospital. The result from the last visit suggested that she had dyslipidemia and uncontrolled hypertension. We recommend the worker with job restrictions. She can still work in the nutrition department of the hospital but with restrictions on cooking duties. She can still work in the food filter and serving area. The goal of limiting work assignments is to maintain chronic kidney failure at stage IV. In addition, the hospital is also required to take control measures so that other workers do not have the risk of kidney disease health problems. Keywords: chronic kidney disease, cook, occupational medicine management
Outcomes of Autologous Reconstruction in Comparison with Alloplastic in Microtia Patients Dini Widiarni Widodo; Irfan Irfan; Eka Dian Safitri; Mirta Hediyati Reksodiputro
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.178.258-64

Abstract

Background: Microtia is a congenital abnormality of the auricle. One of the important comprehensive management of microtia is ear reconstruction. Reconstruction using an auricle framework from autologous material originating from the rib cartilages is still the gold standard. However, currently, some surgeons prefer alloplastic materials which are claimed to reduce morbidity and can be performed at a younger age. Objective: Report a case of a microtia patient who underwent autologous reconstruction followed by a literature search comparing the outcomes of autologous and alloplastic reconstruction. Case: An 11-year-old with grade 3 unilateral microtia who underwent autologous reconstruction surgery using materials from the rib cartilages. Later he complained of pain at the rib grafting site, more than at the surgical wound in the ear. Methods: A literature search based on the clinical question was done in PubMed, EBSCOhost, Cochrane Library, and by hand searching. Results: Three relevant articles that fit the clinical question were included. Autologous reconstruction causes fewer complications, while alloplastic reconstruction is better aesthetically. Further research is needed regarding the quality of life. Conclusion: Auricular reconstruction using autologous material remains the superior material of choice. Alloplastic framework can be an alternative choice with better aesthetic results but greater complication risk.
Profil Klinis dan Radiologis Pasien Stroke dengan Cerebral Small Vessel Disease Di RS Bethesda Yogyakarta Arminta Ni Kadek Aditya Pramesti; Pinzon Rizaldy Taslim; Pramudita Esdras Ardi
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.183.251-7

Abstract

Cerebral Small Vessel Disease (CSVD) merupakan penyebab tersering dari kasus stroke dan bagian utama gangguan kognitif vaskular. Di Indonesia stroke merupakan penyakit penyebab kematian dan disabilitas tertinggi pada tahun 2019, namun data spesifik terkait CSVD di Indonesia masih minim. Melalui tulisan ini, akan di bahas lebih lanjut terkait karakteristik pasien Cerebral Small Vessel Disease. Penelitian ini menggunakan metode deskriptif observasional kuantitatif dengan total 83 subjek penelitian. Ditemukan 73,5% pasien adalah perempuan, dengan 98,8% subjek berusia 50 tahun ke atas. Terdapat beberapa faktor risiko yang ditemukan yaitu: dislipidemia (78,3%), hipertensi (77,1%), diabetes mellitus (39,8%), heart disease (26,5%), dan kidney disease (7,2%). Ditemukan adanya peningkatan pada kadar LDL (143,060±40,469) dan trigliserid (241,024±116,807). Dari 83 subjek penelitian 85,5% mengalami WMH, 59% infark lakunar, dan 51,8% mengalami microbleeds. Lokasi infark lakunar yang ditemukan yaitu: acute frontal, acute parietal, acute fronto parietal, acute fronto temporal, periventricular, pons, dan multiple lacunar, dan 3 manifestasi klinis yaitu pure motoric (43,4%), sensori motoric (50,6%), dan ataxic hemiparesis (6%). Disimpulkan bahwa karakteristik pasien CSVD yaitu perempuan berusia 50 tahun ke atas dengan faktor risiko tertinggi yaitu dislipidemia dengan peningkatan kadar LDL dan trigliserid pasien. Gambaran MRI dan manifestasi klinis terbanyak ditemukan yaitu WMH (85,5%) dan sensori motoric. Kata kunci: Cerebral small vessel disease, faktor risiko, hasil laboratorium, MRI, manifestasi klinis.
Pengaruh Fungsi Ginjal Sebelum Intervensi Koroner Perkutan Primer Terhadap Perbedaan Kesintasan 30 Hari Pasien Infark Miokard Elevasi Segmen ST Fahmi Razi Darkuthni; Sally Aman Nasution; Aida Lydia; Murdani Abdullah; Dono Antono; Cleopas Martin Rumende; Maruhum Bonar Hasiholan Marbun; Hamzah Shatri; Arif Mansjoer; Ika Prasetya Wijaya; Lusiani Lusiani
eJournal Kedokteran Indonesia Vol 10, No. 3 - Desember 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.195.204-11

Abstract

Penyakit jantung koroner merupakan penyebab kematian penyakit kardiovaskular utama di Indonesia. Revaskularisasi fase akut secara mekanis maupun farmakologis merupakan tatalaksana utama pada STEMI. Mortalitas paska revaskularisasi masih tinggi. Salah satu faktor penting yang memengaruhi kesintasan pasien STEMI adalah fungsi ginjal. Gangguan fungsi ginjal yang dicerminkan dengan estimated glomerulus filtration rate (eGFR) < 60 diketahui berhubungan dengan perfusi miokard yang buruk paska IKP primer. Penelitian ini bertujuan untuk memberikan gambaran karakteristik pasien STEMI yang menjalani IKP primer berdasarkan fungsi ginjal sebelum IKP dan menganalisa perbedaaan kesintasan dalam 30 hari pasien STEMI-IKP primer berdasarkan fungsi ginjal sebelum IKP. Metode studi observasional kohort retrospektif dan pengukuran fungsi ginjal dikelompokkan berdasarkan eGFR dengan rumus CKD-EPI menjadi dua yaitu eGFR < 60 dan eGFR ≥ 60. IKP primer dilakukan pada 211 pasien STEMI. Insiden mortalitas eGFR < 60 sebesar 14,7%, sedangkan dengan eGFR ≥ 60 sebesar 4,4%. Perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR (p < 0,05) dengan crude HR (IK95%) 3,433 (1,269-9,284). Tidak terdapat perbedaan kesintasan pasien STEMI-IKP antar-kelompok eGFR setelah di-adjusted. Mortalitas dalam 30 hari pada kelompok eGFR < 60 lebih tinggi dibandingkan dengan kelompok eGFR ≥ 60. Kata kunci: infark miokard akut, intervensi koroner perkutan, fungsi ginjal, mortalitas.

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