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Penyakit Ginjal Kronik merupakan salah satu penyakit tidak menular yang prevalensinya terus meningkat dari tahun ke tahun. Penurunan fungsi ginjal menjadi penyakit ginjal kronik tahap akhir mengakibatkan pasien harus menjalani terapi penganti ginjal semur hidup. Terapi yang paling banyak digunakan saat ini adalah hemodialisis. Meskipun alat hemodialisis telah banyak dan canggih, namun ketahanan hidup pasien PGK masih rendah. Salah satu penyebab rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis adalah komorbiditas atau penyakit penyerta. Komorbiditas yang saat ini paling umum pada pasien PGK yang menjalani hemodialisis adalah diabetes mellitus. Desain penelitian ini menggunakan desain kohort restrospektif. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan dan 1 tahun pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus lebih rendah dibandingkan pasien dengan komorbiditas bukan diabetes mellitus. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan, 1 tahun dan pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus adalah dalah 69%, 55% 34%, dan 34% sedangkan komorbiditas bukan diabetes mellitus adalah 76%, 61%, 53% dan 51%. Secara bivariat, pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus memiliki risiko untuk meninggal 1.75 kali lebih cepat dibandingkan dengan pasien komorbiditas bukan diabetes mellitus. Sementara itu dari analisis multivariat didapatkan variabel konfonder yang mempengaruhi rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis pada pasien dengan komorbiditas diabetes mellitus adalah akses vaskular.
Chronic kidney disease (CKD) is one of the no-communicable diseases which increase every years. The decline of kidney function will progress to End Stage Renal Disease (ESRD). The ESRD patients has to undurgo dialysis therapy during their lives. the most dialysis therapy is hemodialysis. Although the machine of hemodialysis are quiet a a lot and sophisticate, the survival of CKD patients is still low. One of the causes of low survival PGK patient on maintenance hemodialysis is the comorbid or present disease. Nowadays the most common comorbid for CKD patient with hemodialysis is diabetes mellitus. Research design is using Kohort Retrospective. The probability of survival of 3 months,6 months, 9 months and 1 year CKD patients on maintenance hemodialysis with comorbid diabetes mellitus is lower than patients without comorbidities of diabetes mellitus. The probability ofsurvival of 3 months, 6 months, 9 months, 1 year and CKD patients on maintenance with comorbid diabetes mellitus are 69%, 55% 34%, and 34% while one not comorbid diabetes mellitus are 76%, 61%, 53 % and 51%. In bivariate analysis,CKD patients on maintenance hemodialis with comorbid diabetes mellitus have a risk of dying 1.75 times faster than patients without comorbiddiabetes mellitus. Meanwhile obtained from multivariate analysis confonder variables that affect the low survival of CKD patients on maintenance in patients with comorbid diabetes mellitus is a vascular access.
Type 2 diabetes mellitus is a non-communicable disease that can be treated, and its consequences can be prevented or delayed through proper diet, physical activity, medication, as well as regular screening and treatment of complications. However, this disease is often diagnosed several years after onset, by which time complications and comorbidities may have developed, making it one of the top 10 causes of hospitalizations. This study aims to determine the effect of severity and comorbidity on the length of hospital stay among patients with type 2 diabetes mellitus in advanced referral health facilities (FKRTL) among BPJS Kesehatan participants in 2023, controlled for variables such as FKRTL type, FKRTL ownership, segmentation, care class, age, and gender. This research used 2023 BPJS Kesehatan sample data with a cross-sectional study design. The analysis included univariate, bivariate, and multivariate methods. Bivariate analysis showed a significant relationship between severity and length of stay (p-value = 0.001), while comorbidities were not significantly associated with length of stay (p-value = 0.285). Moderate to severe severity and comorbidities with a CCI score of ≥1 were associated with a higher risk of prolonged hospitalization and a lower risk of short hospitalization compared to the ideal length of stay (RRR = 4.95; 95% CI = 0.82–29.85; RRR = 0.46; 95% CI = 0.29–0.72 | RRR = 1.11; 95% CI = 0.25–4.92; RRR = 0.67; 95% CI = 0.41–1.10). Multivariate analysis controlling for FKRTL type, FKRTL ownership, segmentation, care class, age, and gender showed that the association between severity and length of stay remained significant after controlling for FKRTL type and FKRTL ownership, while the association between comorbidity and length of stay remained insignificant even after adjusting for control variables. Efforts to enhance clinical early detection programs for the severity level and comorbidities of type 2 diabetes mellitus are necessary to prevent prolonged hospital stays due to complications and disease severity, which contribute to a significant healthcare burden.
dependent Infant survival is defined as the ability of infants to survive through life up to 1 year old. Infant survival is the opposite of infant mortality is the death that occurred between after birth until the baby has not exactly 1 year old. In 2012, Indonesia IMR reported as 32 per 1,000 live births. This figure is relatively high compared to the Asia countries with similar socio-economic conditions. Moreover, the gap of IMR also occurred in socio-economic level within Indonesia. Socio-economic status is the primary factor determining survival of infants. Socio-economic status will affect infant survival through maternal factors, nutrition, baby's condition at birth, disease control and environment. This study aims to reveal the infant survival in Indonesia and its determinants based on data IDHS 2012. This study uses Indonesia Demographic and Health Survey 2012. The result shows that probability of infant survival in Indonesia amounted to 97,8%. Infant survival decreased sharply in the first months of age 1, wherein the proportion of infant deaths in the neonatal period amounted to 53.8% and neonatal deaths occurred in the age of 0-7 days, by 80%. Based on the results of time-dependent Cox regression, the variables entered into the multivariate model were maternal age when gave birth (20-35 years, HR = 1.9), Maternal employment (officer/employee, HR = 2.2; informal sector/industrial, HR = 3.3 ; agriculture, HR = 2.1), birth weight (<2500 grams, HR = 5.9; not weigh, HR = 2.0), prelakteal feeding (HR = 1.5), post-delivery checked (not checked, HR = 2.2). There is interaction between time with the effects of low birth weight and post- delivery checked in the multivariate model obtained. Keywords : Infant survival, infant death, socio-economics, neonatal, cox time dependent regression
Tujuan: untuk mengetahui karakteristik pasienDM tipe 2 di RSUP NTB tahun 2012-2013, serta mengukur asosiasi sederhana DSME terhadap lama hari rawat pasien di RSUP NTB. Desain dan
Metode: Tinjauan secara retrospektif terhadap 199 rekam medis pasien DM tipe 2.
Hasil: DSME disampaikan oleh perawat dan ahli gizi. Akan tetapi, tidak seluruh pasien mendapat edukasi. Di RSUP NTB, yang tercatat edukasi tentang: diet (53%),aktivitas fisik (33%), tentang obat (8%), komplikasi (1%), edukasi lainnya (6%),dan 27% pasien yang tidak mendapat edukasi apapun oleh perawat. Sebanyak 43.7% pasien yang mendapat konseling gizi oleh ahli gizi. Pasien yang mendapatDSME memiliki lama hari rawat yang lebih singkat dibandingkan dengan yang tidak mendapat edukasi.
Kesimpulan: berdasarkan catatan rekam medis DSMEdi RSUP NTB belum optimal dan DSME berperan mempersingkat lama harirawat pasien.
Kata kunci: Diabetes Self Management Education, DM tipe 2, lama hari rawat,rawat inap, RSUP NTB.
Background: Type 2 Diabetes Mellitus (type 2 DM) is a disease that can not becured. An adequate education is one of way management of type 2 DM. DiabetesSelf Management Education (DSME) in hospitals not adequate and impact onlength of stay.
Purpose: this study to describe characteristics of patients withtype 2 DM at General Hospital West Nusa Tenggara 2012-2013, and measuredassociation of DSME to length of stay.
Design and Method: Descriptiveresearch method with retrospective design. Number of samples involved in thisstudy is 199 medical records of patients with type 2 DM.
Result: DSMEdelivered by nurses and nutritionists. But, not all patients get DSME. DSMErecorded was about: diet (53%), exercises (33%), medicines (8%),complications of type 2 DM (1%), other education (6%), and 27% of patients donot get any DSME. Patients with DSME has shorter length of stay than patientwithout DSME.
Conclusion: according to medical records, DSME at GeneralHospital West Nusa Tenggara 2012-2013 is not optimal and DSME role inlength of stay of patients with type 2 Diabetes Mellitus.
Keywords: Diabetes Self Management Education; type 2 DM; length of stay,inpatient, RSUP NTB.
Tujuan: Untuk mengetahui Faktor-Faktor Yang Mempengaruhi Orang Dengan Hipertensi Terhadap Kejadian Diabetes Mellitus di Kota Depok.
Metode Penelitian: Penelitian ini menggunakan desain cross-sectional, dengan data sekunder yang diperoleh dari Badan Pusat Statistik dan Sistem Informasi Penyakit Tidak Menular (SIPTM) Dinas Kesehatan Kota Depok.
Hasil: Jumlah kasus Diabetes Mellitus di Kota Depok pada tahun 2017-2019 semakin fluktuatif. Pada tahun 2017 ditemukan kasus Diabetes Mellitus sebanyak 245 kasus, sedangkan pada tahun 2018 dan 2019 secara berturut-turut ditemukan sebanyak 282, dan 315 kasus. Jumlah kasus Diabetes Mellitus di Kota Depok lebih banyak ditemukan karena adanya pola gaya hidup yang tidak sehat, riwayat keluarga, dan kurangnya aktivitas fisik pada seseorang Selain itu tidak adanya korelasi antara jumlah fasilitas kesehatan dan tenaga kesehatan terhadap jumlah kasus Diabetes Mellitus.
Kata Kunci: Diabetes Mellitus, Faktor Risiko, Hipertensi, Penyakit Tidak Menular.
