Latar belakang. Pneumonia merupakan penyebab utama kematian pada anak usia di bawah lima tahun di negara berkembang. Pengembangan sistem skor yang sederhana untuk memprediksi kematian pada pneumonia dapat meningkatkan kualitas pelayanan dan menurunkan angka kematian anak akibat pneumonia. Tujuan. Menyusun skor prediksi kematian pada anak dengan pneumonia. Metode. Penelitian kohort retrospektif pada anak (umur 2 bulan sampai 5 tahun) yang dirawat di RSUP Dr. Sardjito dengan pneumonia sejak Januari 2009 sampai Desember 2014. Anak dengan rekam medis tidak lengkap atau dengan infeksi HIV dieksklusi. Digunakan metode Spiegelhalter Knill-Jones untuk penyusunan skor kematian. Prediktor kematian dengan likelihood ratio (LHR) ≤0,5 atau ≥2 dimasukkan dalam sistem skor. Cut off point dari skor total ditentukan dengan kurva receiver operating characteristic (ROC). Hasil. Di antara 225 anak yang memenuhi kriteria, 42 (18,7%) meninggal. Prediktor kematian yang memenuhi kriteria LHR adalah usia <6 bulan (LHR 2,05), takikardia (LHR 2,11), saturasi oksigen (SpO2) <92% (LHR 2,54), anemia (LHR 0,38) dan leukositosis (LHR 2,04). Skor prediksi kematian terdiri atas usia (skor=5 bila usia <6 bulan dan 0 bila >6 bulan); frekuensi nadi (skor=6 bila takikardia dan -8 bila normal); saturasi oksigen (skor=3 bila SpO2 <92% dan 0 bila SpO2 >92%); hemoglobin (skor=4 bila anemia dan -6 bila normal), leukosit (skor=3 bila leukosit dan 0 bila normal). Total skor >3 mempunyai sensitivitas dan spesifitas terbaik, yaitu 85,7% dan 72,1%. Kesimpulan. Skor prediksi kematian pneumonia >3 dapat digunakan untuk memprediksi kematian pada anak dengan pneumonia. Sari Pediatri 2016;18(3):214-9Kata kunci: pneumonia, kematian, prediksi, skor
Pneumonia Mortality Prediction Score for Children under Five Years of AgeAmbarsari S. N. Latumahina, Rina Triasih, Kristia Hermawan Background. Pneumonia is a leading cause of mortality in children under five years of age. Development of a simple score to predict death in pneumonia can improve the quality of care and reduce childhood mortality from pneumonia. Objective. To develop mortality prediction score in children with pneumonia. Methods. We conducted a retrospective cohort study of children (2 months to 5 years) who were admitted to Sardjito hospital with pneumonia between 2009 and 2014. Those with incomplete data and HIV infection were excluded. We used the Spiegelhalter Knill-Jones method to develop the scoring system. Factors with a likelihood ratio (LHR) ≤ 0.5 or ≥ 2 were retained to develop the prediction score. Cut off point of total score was determined with ROC curve. Results. Of 225 eligible children, 42 (18.67%) died. Factors with eligible LHR were age <6 months (LHR 2.05), tachycardia (LHR 2.11), SpO2 <92% (LHR 2.54), anemia (LHR 0.38) and leukocytosis (LHR 2.04). The mortality prediction score consists of age (score= 5 if age <6 months and 0 if > 6 months); heart rate (score= 6 if tachycardia and -8 if normal); oxygen saturation (score= 3 if SpO2 <92% and 0 if SpO2 >92%); hemoglobin (score= 4 if anemia a...
were breast cancer (5%), gastrointestinal (4%), and gynaecological (2%) malignancy. Discussion: Further studies are needed to clarify whether there may be an association between takotsubo cardiomyopathy and metabolic conditions such as endocrinopathies or malignancies. Understanding the neurohormonal milieu may facilitate targeted management of takotsubo cardiomyopathy.
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