Background:The COVID-19 pandemic presents a challenge to control patients with chronic disease and conditions, because many people have postponed regular visit for chronic health condition such as hypertension. To make things worse, hypertension is the most important comorbidities and predictor of poor outcomes from COVID-19. Blood pressure control become more crucial to be top priority during this pandemic and beyond.Objective: The aim of this study is to determine the blood pressure control status among hypertensive patient in outpatient settings during the pandemic, as compared to before the pandemic of COVID-19.Methods: This retrospective, comparative cross-sectional study included 108 medical records of patients with hypertension diagnosis in outpatient cardiology clinic, at Sanglah General Hospital in January 2021. The data obtained were blood pressure during pandemic in January 2021, compared to blood pressure in the same patient before the pandemic (before March 2020).
Result:The proportion of controlled hypertension before pandemic era was 49.1%, and has decreased during the pandemic to 39.8% (p value=0.123). Wilcoxon signed rank test showed that there was increased systolic blood pressure level between before pandemic compared to during pandemic of COVID-19 (p value=0.041).
Conclusion:The optimal management of hypertension become a very important issue during pandemic of COVID-19, since patients with this pre-existing condition could experience severe complications when infected with SARS-CoV-2. The alternatives to hospital and community-based care, such as mobile phone consultation or telemedicine can be developed by the multidiscipline collaboration to increase control status of hypertension.
Introduction: Hemodialysis requires invasive vascular access (VA) procedure which could emerge deep venous thrombosis (DVT) complication. Apart from VA, other risk factors, either modifiable or unmodifiable, could increase DVT risk. Those factors can be assessed by Padua Prediction Score (PPS). This study aims to assess which risk factors in PPS increase the risk of developing DVT in routine hemodialysis patients at BHCC main clinic.
Methods: This research is a descriptive observational study with simple random sampling. The participants were 58 routine hemodialysis patients in BHCC. The inclusion criteria of this study were the ages above 17 years old, had history hemodialysis more than one, the patient willing to become of the sample subject. The patient that incompletely fulfills the questionnaire were already treated with anticoagulation were admitted for VTE, and had a history of discontinuing hemodialysis were excluded. The data were gathered using a questionnaire according to PPS. The data was analyzed by using SPP 25.0. The descriptive data was provided in a table and pie chart.
Results: Based on the results of the PPS, 11 patients (18.96%) were among the high risk, and 47 patients (81.04%) were at low risk. The most potent risk factor in increasing the risk of DVT is reduced mobility with a risk priority number (RPN) of 30 (severity=3, occurrence=10). Recent (≤one month) trauma and surgery entail on second with an RPN of 24 (severity=2, occurrence=12). The third is occupied by heart and/or respiratory failure with a RPN of 14 (severity=1, occurrence=14). Previous VTE history with a RPN of 12 (severity=3, occurrence=4) placed fourth, followed by age≥ 70 (RPN=8, severity=1, occurrence=8) and obesity (BMI>= 30) with a RPN of 4 (severity=1, occurrence=4) at fifth and sixth respectively.
Conclusion: "Reduced mobility" is the most prominent risk factor to increase DVT risk in routine hemodialysis patients, followed by other risk factors. Reduced mobility and obesity are modifiable risk factors that should be eliminated by educating routine hemodialysis patients.
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