Background: Fournier’s gangrene is a rare and rapidly progressive, necrotizing fasciitis affecting the external genitalia and perineum. Based on the case series that have been reported, the incidence rate of this case is 88% with mortality rate of 20%-40%. The study aims to share our policy in managing Fournier’s gangrene and identifying risk factors that can affect the outcome of defect closure.Method: The medical records of 10 patients with Fournier’s gangrene who presented at the Dr. Soetomo Hospital Surabaya from January 2017 to December 2018 were reviewed retrospectively. We analyzed characteristics of the patients, risk factors, methods of defect closure, and case outcome. There are 10 Fournier’s gangrene patients at Dr. Soetomo Academic General Hospital from January 2017 to December 2018. We analyzed the patient’s medical records retrospectively on the patient’s characteristics, risk factors, method of closing Fournier’s gangrene defects, and the final outcome of the case.Results: There were ten men enrolled in the study, and the mean age was 49.3 ± 11.51 years. All patients received broad-spectrum antibiotic therapy, and extensive surgical excision. This study found that diabetes mellitus and uncontrolled patient blood sugar levels, statistically there is no effect on failure of defect closure in Fournier gangrene patients, but clinically, the relative risk value shows that blood glucose levels have a risk factor of 6 times. increasing the incidence of failure to close the Fournier gangrene defect.Conclusions: Fournier’s gangrene is still considered a severe disease with fairly high mortality rate. Early recognition of predisposition factors associated with invasive and aggressive treatment options is very important in efforts to to reduce morbidity.
Background: Length of stay (LOS) is one of contributor in hospital costs, and attention has been paid to reducing LOS without compromising the quality of care for patients. Hospitals with a burn center have a longer average LOS than hospitals without a burn center, which can result in higher hospitalization costs. This study aims to identify the epidemological and clinical factors that affect LOS in burn patients. Methods:We conducted a retrospective cross-sectional study in design included all patients admitted to the Burn Center Soetomo General Hospital Surabaya between January 2017 -December 2019 who arrived within 48 hours after injury and survived till discharge. Patients who arrived after 48 hours following the injury, death during treatment and discharge against medical advice are excluded. Epidemiological and clinical data, such as age, gender, pre-existing co-morbidities, total body surface area (TBSA) burn wound, depth of burn, inhalation trauma, burn etiology, hospital acquired pneumonia (HAP), sepsis, anemia and hypoalbuminemia collected and subjected to statistical analysis.Results: Of all 249 patients admitted, 136 patients are eligible in the inclusion criteria. Median LOS in the total population was 17 days. The population most often treated for more than 28 days is a patient with a burn area of 30.5-40%, experiencing HAP and hypoalbuminemia. LOS significantly increased with TBSA, inhalation trauma, comorbidities, HAP, sepsis, anemia and hypoalbuminemia. Conclusion:There are several factors associated with the increased LOS observed in burn patients. This study confirmed and identified new factors that were significantly associated with LOS and were not previously discussed in the literature which allows better prediction of LOS and management of patients with burn injuries.
Latar belakang: Hemangioma infantil merupakan tumor yang banyak ditemukan pada anak-anak. Di Indonesia sendiri, data mengenai faktor risiko hemangioma infantil ini masih belum terdokumentasikan dengan baik. Namun dengan adanya data demografis, faktor-faktor prenatal dan perinatal pada pasien hemangioma infantil dapat membantu klinisi untuk mendalami patogenesis kelainan ini dengan lebih baik. Diharapkan dalam penelitian ini, adanya data demografis ini dapat membantu peneliti lainnya untuk melakukan analisis lebih lanjut mengenai patogenesis, diagnosis, tatalaksana, maupun luaran pasien dengan hemangioma infantil.Metode Penelitian: Penelitian ini merupakan studi case control. Sebanyak 67 subyek hemangioma infantil dan 134 subyek hemangioma non infantil diambil dari data rekam medis. Kemudian data diolah dan disajikan untuk melihat angka kejadian dan presentase antar faktor resiko terhadap kejadian hemangioma infantil. Data yang diambil yaitu jenis kelamin pasien, berat badan, usia ibu saat hamil, usia kehamilan saat melahirkan, riwayat multipel gestasi, riwayat penggunaan obat-obatan saat kehamilan dan riwayat keluarga dengan hemangioma infantil. Kemudian dianalisis secara univariat, bivariat dan multivariat dengan program spreadsheet Microsoft Excel SPSS 21.Hasil: Faktor resiko ibu yang berusia antara 22-30 tahun untuk melahirkan anak dengan hemangioma infantil 4,257 kali lebih besar dibandingkan dengan usia ibu kurang dari 22 tahun. Faktor resiko ibu yang berusia lebih dari 30 tahun untuk melahirkan anak dengan hemangioma infantil 9,960 kali lebih besar dibandingkan dengan usia ibu kurang dari 22 tahun. Faktor resiko pasien dengan adanya riwayat keluarga dengan hemangioma memiliki resiko 14,175 kali lebih besar dari pada yang tidak memiliki riwayat hemangioma infantil atau kelainan vaskular di keluarga. Faktor resiko penggunaan obat prekonsepsi selama kehamilan memiliki resiko 4,914 kali lipat daripada yang tidak menggunakan obat prekonsepsi selama kehamilan. Kesimpulan. Hemangioma infantil lebih sering terjadi pada perempuan dengan rata-rata berat badan lahir cukup. Paling banyak terjadi pada ras Melayu dibandingkan dengan ras Cina. Tidak adanya hubungan antara riwayat multipel gestasi dengan kejadian hemangioma infantil. Resiko ibu yang berusia 22-30 tahun untuk melahirkan anak dengan hemangioma infantil lebih besar dibandingkan dengan usia ibu kurang dari 22 tahun, dan usia ibu lebih dari 30 tahun memiliki faktor resiko lebih tinggi dibandingkan dengan usia ibu kurang dari 22 tahun. Adanya riwayat keluarga dengan hemangioma infantil memiliki resiko lebih besar daripada yang tidak. Penggunaan obat-obatan selama kehamilan memiliki resiko terjadinya hemangioma infantil daripada yang tidak.
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