Background: The SARS-CoV-2 infection has triggered a global health crisis. Early detection of COVID-19 infection using hematology and radiology examination is the fastest method to detect the infection. This study aims to evaluate the characteristics of sign and symptom, hematology, and radiology examination of COVID-19 patients at Universitas Gadjah Mada (UGM) Academic Hospital, Yogyakarta, Indonesia.Methods: This is a retrospective study with quantitative descriptive methods and uses a total sampling technique. This study was conducted at UGM Academic Hospital, with a total sample of 147 patients diagnosed with COVID-19. Data were collected from medical records and were analyzed with Microsoft Excel for Windows.Results: This study showed that the most signs and symptoms of COVID-19 patients were cough (46.26%) and cold (37.41%), followed by hypertension (31.97%). Hematology examination showed that the leukocyte count of patients was mainly higher than the normal level (82.99%). The data showed that 22.45% of patients had increased C-Reactive Protein (CRP) and 2.72% of patients had increased procalcitonin. The result of thorax x-ray (16.33%) and CT-scan (28.57%) examination of the COVID-19 patients indicates pneumonia.Conclusions: This study illustrated that the symptoms of COVID-19 patients at UGM Academic Hospital, Yogyakarta were various. Respiratory problems such as cough and cold were the most common symptoms, followed by muscle fatigue and digestive disorders. Hematology and radiology test results of COVID-19 patients depend on the severity of the disease.
The early warning system (EWS) has been decided as a new standard for Indonesian hospitals. The main objective of EWS implementation is to help nurses quickly recognize and react to deteriorating patients. This study explores how EWS contributes to nurses’ clinical decisions around patient deterioration. The research design for this study was mixed-method sequential explanatory. A purposive sampling approach was used to recruit the participants. Closed and open-ended questionnaires were distributed (n = 53) to adult unit nurses and the data was analyzed by using descriptive statistics. Focus group discussions were conducted to evaluate the implementation process and the results obtained were analyzed by using thematic analysis. Both data were integrated by using a joint display table. We found that 79% of nurses indicated that they needed education about how to use the EWS and 92% of nurses required education on physiology and management of the deteriorating patient. Three themes emerged: (1) the nurses’ experience of EWS Implementation, (2) the impact of EWS implementation, and (3) ameliorating the EWS Implementation. The participants showed that the EWS has been used for the assessment, documentation, and communication process of deteriorating patient management. The EWS is a complex tool for nurses, and they need support from stakeholders to maintain and optimize the advantages.
The SARS-CoV 2 virus pandemic has been a scourge since 2020. The number of cases that continues to increase, both mild, moderate, severe-critical confirmed cases are directly proportional to the need for treatment rooms, both ordinary wards and intensive care units (ICU), which is inversely proportional to the available capacity. room. Based on research, the high mortality and morbidity rate due to COVID 19 is due to the incidence of patient sepsis. Research abroad states that the value of D-dimer is a prognostic factor for COVID-19 patients, although there is no agreement on the best cut-off point for specificity and sensitivity. hypercoagulability conditions and increased lactic acid in patients with severe sepsis. It is necessary to evaluate the role of this laboratory result in estimating the prognosis of COVID-19 patients in Indonesia. There is no study that examines the relationship between the incidence of sepsis and the characteristics of hypercoagulability with the dominance of the thrombotic process in COVID19 patients in Indonesia. The purpose of this study was to provide information to health workers about the role of D-dimer value as a prognostic factor for severe-critical COVID-19 patients. This quantitative retrospective research data in the form of proportions were collected for 12 months from the medical records of the UGM Academic Hospital of patients with confirmed severe-critical COVID-19. Overall survival was assessed by the Kaplan-Meier curve. The cut-off determination for the D-dimer variable was carried out using the Receiver Operating Curve (ROC) followed by the calculation of the Youden index. Then the hazard ratio was determined by cox regression with a p value of <0.05 which was considered significant. Statistical analysis with SPSS version 26 software.
The value of D-dimer value, lactic acid levels, and the results of blood gas analysis (PaO2, PCO2, PH, and PaO2/FiO2) are prognostic factors for COVID-19 patients, although there is no agreement on the optimum cut-off point for specificity and sensitivity. The aim of this study is to examine D-dimer value, lactic acid levels, and the results of blood gas analysis as a prognosis for patients with severe or critical COVID-19. This was a retrospective study of the medical records of the UGM Academic Hospital. Overall survival was assessed by the Kaplan-Meier curve. Determination of the cut-off for D-dimer, lactic acid, and BGA variables was carried out using the ROC followed by calculating the Youden index. Then the hazard ratio was determined by Cox regression. The cut-off value to determine the group of patients on the D-dimer and lactic acid variable was 881 ng/mL (sensitivity 77.23%, specificity 32.31%) (p=0.040) and 21 ng/mL, patients with lactic acid values above the cut-off had a higher risk of death (p=0.391). The cut-off of pH, PaO2, and PaCO2 were 7.43, 72.2 mmHg, and 33.9, respectively. D-dimer levels, lactic acid, and PaCO2 values in blood gas analysis above the cut-off value had a worse survival rate, while patients also had a worse survival rate if the PaO2 and PH values were below the cut-off value.
The value of D-dimer value, lactic acid levels, and the results of blood gas analysis (PaO2, PCO2, PH, and PaO2/FiO2) are prognostic factors for COVID-19 patients, although there is no agreement on the optimum cut-off point for specificity and sensitivity. The aim of this study is to examine D-dimer value, lactic acid levels, and the results of blood gas analysis as a prognosis for patients with severe or critical COVID-19. This was a retrospective study of the medical records of the UGM Academic Hospital. Overall survival was assessed by the Kaplan-Meier curve. Determination of the cut-off for D-dimer, lactic acid, and BGA variables was carried out using the ROC followed by calculating the Youden index. Then the hazard ratio was determined by Cox regression. The cut-off value to determine the group of patients on the D-dimer and lactic acid variable was 881 ng/mL (sensitivity 77.23%, specificity 32.31%) (p=0.040) and 21 ng/mL, patients with lactic acid values above the cut-off had a higher risk of death (p=0.391). The cut-off of pH, PaO2, and PaCO2 were 7.43, 72.2 mmHg, and 33.9, respectively. D-dimer levels, lactic acid, and PaCO2 values in blood gas analysis above the cut-off value had a worse survival rate, while patients also had a worse survival rate if the PaO2 and PH values were below the cut-off value.
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