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Objective: This study aims to determine the risk of recurrent strokein patientswith post-stroke first in the brain center of the national hospitaland the risk factorsthat influence.Methods: This study was a retrospective cohort. The sample in this study is thefirst to attack all stroke patients who underwent inpatient services in 2014 and hada complete medical record. Analysis of data using multivariate cox regression.Results: The results showed that in ≤ 15, ≥ 60 years of age have a greater risk forrecurrent stroke; in <15 overweight have a higher risk for recurrent stroke; in ≤15, obesity have a higher risk for recurrent stroke; in ≤ 30, pre-hypertension are athigher risk forrecurrent stroke; in ≤ 15, hypertension grade 1 and 2 have a higherrisk for the recurrent stroke; control irregular had 8.71 times higher risk forrecurrent strokeKey words : Survival analysis, reccurrent stroke, stroke.
The World Health Organization recommends at least 6 months of exclusive breastfeeding (EBF). In fact, the rate of exclusive breastfeeding in Indonesia is relatively low, which is around 30-50%.This study was aimed to assess the duration of breastfeeding among women of reproductive age in Indonesia and to identify determinants associated with duaration of exclusive breastfeeding at the individual and group levels. This study used a cross-sectional design with a sample of 1109 mothers of infants aged 1-5 months. Data were obtained Indonesian Health Demographic Survey 2017 and analyzed using survival analysis. The Kaplan-Meier survival estimate showed that the cumulative survival probability breastfeding without supplementary feeding was low (22.9%) with a median time survival of 5 months. Cox extendend regression analysis showed that working mothers, no early initiation of breastfeeding and middle economic status were significant determinants of early cessation of breastfeeding without supplementary feeding. The main predictor of cessation was working mothers at observation times of less than 3 months (HR=1.35 95% CI 1.05 ? 1.73). Then, we recommend that the exclusive breastfeeding-promotion programs in Indonesia should give special attention to working mothers and create a supportive work environment.
Background: The patients prevalence who experience worsening clinical conditions on the general ward is 15-20%, which causes a serious outcome, namely death. Mortality events in this group of patients who were called rapid response team were influenced by high NEWS score points. Objective: To determine the association between NEWS and mortality in patients who have called TMRC at Dr. Cipto Mangunkusumo Hospital. Methods: This study used a retrospective cohort design from the medical records of patients who have called TMRC in all hospital areas except the operating room, intensive care, and emergency department. The sample was selected using total sampling, analyzed using Kaplan-meier survival analysis and cox extended model analysis. Results: Patients who have called TMRC with a high NEWS score in less than 15 days had increased risk of mortality aHR 2,86, 95% CI 2,18?3,77, p-value 0,000 in those who did not have chronic liver disease. Meanwhile, in patients with a high NEWS score who had chronic liver disease the risk of mortality increased to aHR 4,17, 95% CI 1,39?12,44, p-value 0,01 after being controlled with sepsis. Conclusion: A high NEWS score at less than 15 days had almost 3-fold increased risk of mortality in those without chronic liver disease. Meanwhile, in patients who have chronic liver disease, the risk of mortality increases to 4 times after being controlled with sepsis.
Abstrak Proporsi keberhasilan pengobatan pasien TBC di Jakarta Barat trend-nya mengalami penurunan dari tahun 2020 hingga 2022. Penelitian ini bertujuan untuk mengetahui hubungan kepatuhan pengobatan, co-infeksi HIV, dan riwayat pengobatan dengan ketidakberhasilan pengobatan TBC SO di Kota Jakarta Barat tahun 2022. Desain studi penelitian yaitu kohort retrospektif, bersumber dari laporan TB03.SO Sistem Informasi Tuberkulosis (SITB) Kota Jakarta Barat tahun 2022. Analisis penelitian meliputi analisis deskriptif, survival dengan Kaplan Meier, dan multivariat (cox regression). Dari 2116 pasien yang terdapat 1846 pasien menjadi sampel penelitian. Hasil penelitian menunjukkan insiden rate kumulatif: 4,9/1000 orang-minggu; probabilitas survival kumulatif: 70,5%. Pada kelompok negatif DM, tidak patuh minum obat HR: 47,78 kali (95% CI: 32,59-70,03; p-value: <0,001). Pada kelompok ada riwayat pengobatan, tidak patuh minum obat HR: 26,28 (95% CI: 12,54-55,03; p-value: <0,001) setelah dikontrol variabel jenis kelamin. Pada kelompok patuh pengobatan, pada saat pasien TBC SO memiliki riwayat pengobatan sebelumnya memiliki HR: 2,3 (95% CI: 1,06-5,01; p-value: 0,035). Diharapkan menguatkan koordinasi dengan poli lainnya (Poli HIV/PDP atau Poli Penyakit Dalam) untuk memantau keteraturan minum OAT dan juga obat untuk penyakit penyerta lainnya untuk kasus TBC dengan komorbid. Perlu dilakukan pemantauan efek samping, konsultasi, tatalaksana efek samping sesuai standar, dan juga follow up pengobatan pasien. Kata kunci: Ketidakberhasilan Pengobatan, TBC Sensitif Obat, Analisis Survival
Abstract The proportion of successful treatment for TB patients treated in West Jakarta has decreased by 83.40% (2020), 79.36% (2021), and 77.18% (2022) (22.82% failure) . This study aims to determine the relationship between treatment adherence, HIV co-infection, and previous treatment history with TB SO patient survival and treatment failure in West Jakarta City in 2022. The study design of this research is a retrospective cohort with data sourced from the TB03.SO System report. Information on Tuberculosis (TBC SO) for West Jakarta City for the period January-December 2022. The analysis used in this research is descriptive analysis, survival using Kaplan Meier, and multivariate using cox regression. Of the 2116 eligible patients in this study, 1846 patients were included in the research sample. The results showed that the cumulative incidence rate was 4.9/1000 person-weeks with a cumulative survival probability of 70.5%. in the DM negative group, when TB SO patients were non-compliant with taking medication HR: 47.78 times (95% CI: 32.59-70.03; p-value: <0.001) after controlling for the gender variable. The results of the multivariate analysis showed that in the group with no history of treatment, when TB patients did not adhere to taking medication, the HR was: 65.65 times (95% CI: 43.09-100.03; p-value: <0.001) after controlling for variables gender. In the group with a history of treatment, when TB patients did not comply with taking medication, the HR was 26.28 times (95% CI: 12.54-55.03; p-value: <0.001) after controlling for the gender variable. in the treatment adherent group, when TB SO patients had a history of previous treatment, the HR was: 2.3 times (95% CI: 1.06-5.01; p-value: 0.035). It is hoped that coordination with other polyclinics (HIV/PDP Polyclinic or Internal Medicine Polyclinic) will be strengthened to monitor the regularity of taking OAT and also medication for other comorbidities for TB cases with comorbidities, for example ARVs for HIV patients and DM therapy for DM patients. It is necessary to monitor side effects, consult, manage side effects according to standards, and also follow up on patient treatment so as to increase treatment compliance and reduce the rate of treatment failure. Key words: Treatment Unsuccessful, Drug-Sensitive Tuberculosis, Survival Analysis
