BACKGROUND: The histopathological grades identification is unquestionably essential to determine the most effective approach in oncologic management, specifically in breast cancer (BC) as the most common malignancy diagnosed worldwide. Complex and micro-level alterations of coagulation function of the host may occur at some point since the reactivity of the tumor cells byproduct will dysregulate its physiologic function; as represented by the higher rate of fibrinolysis which in turn increase the D-dimer level. AIM: The study aims to provide the correlation between the level of d-dimer and histopathological grades in BC patients. METHODS: A total of 111 females with confirmed BC were included in this study, which was conducted from March to September 2021 at the teaching hospital of Universitas Sumatera Utara. After thorough clinical information analysis, the histopathological examination (HPE) was conducted to confirm the malignancy and graded based on the Bloom-Richardson grading system; therefore, the HPEs were classified into slow/moderate or poorly differentiated. The D-dimer value of >0.5 mg/L was indicated as an elevated level. RESULTS: From the 102 eligible patients to be included in the final evaluation, it was observed that 46.1% and 52.9% of the participants were presumed with elevated D-dimer level and high-grade carcinoma, respectively. The elevated D-dimer level results percentage was substantially more common in high-grade BC (72.3%, the positive predictive value analysis. Other parameters, for example, sensitivity (63.0%), specificity (72.9%), and negative predictive value (63.6%) were found to be statistically accurate (p < 0.001). CONCLUSION: The influence of tumor cells differentiation toward coagulation system or fibrin metabolism dysfunction is observable in this study. Hence, the role D-dimer level measurement should be investigated further to assist the BCs’ grading determination workup.
Background: Assessment of length of stay and mortality in patients with burn injuries is essential to support clinicians in making clinical decisions. In Indonesia, there are several scoring systems used by hospital centers to assess the mortality of burn patients, such as the Belgian Outcome of Burn Injury (BOBI) and the Abbreviated Burn Severity Index (ABSI). However, different results were obtained in studies that examined the comparison of the results of the scoring system. Method: The type of research used in this research is unpaired comparative analysis research using a cross-sectional design. The data to be used is secondary data taken from medical records. Results: Respondents with death status were found in the serious, severe, and maximum ABSI categories, p=0.001 (p<0.05) and the BOBI 50% category as many as three people and 85% as many as one person, p=0.0001 (0<0.05). Length of stay based on the ABSI score for the length of stay was 23 days with an ABSI score of 12-13 (maximum), and based on the BOBI Score, the majority was 28 days with a BOBI score of 8 (85%). ABSI in this study had a sensitivity of 100% and a specificity of 86.4%, while the use of BOBI in this study had a sensitivity of 100% and a specificity of 88.1%. Discussion: The BOBI scoring system is more accurate than the ABSI. This difference may occur due to differences in demographics and quality of service in each region. Therefore, the analysis of the validity of the scoring model before the research is carried out in a new population is considered crucial to be carried out.
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