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Jurnal Vol1. No.1

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ARTIKEL - Mei 2004, Vol.1, No.1

PENGARUH PERUBAHAN STATUS GIZI PASIEN DEWASA TERHADAP LAMA RAWAT INAP DAN BIAYA RUMAH SAKIT

R. Dwi Budiningsari1, Hamam Hadi2

ABSTRACT

Background
: The decline in nutritional status of hospitalized patients was reported to be assossiated with longer length of stay and higher hospital charges. However, the effect of changes in nutritional status on hospital outcomes in Indonesia is still unknown.
Objective : To determine the effect of changes in nutritional status on length of stay and hospital charge among adult hospitalized patients.
Method : A total subjects of 262 adult patients who were admitted to internal and neurology departments of Dr. Sardjito, Dr.M.Jamil, and Sanglah hospitals were included in this study. Nutritional status of each patient was assessed using Subjective Global Assessment(SGA) method. Information on length of stay and hospital charge was collected based on medical records.
Result : Subjects with nutritional status declined from normally to moderately, normally to severely, and moderately to severely malnourished were 6,3 (OR=6.32,95% CI=1,3-29,8); 11,9 (OR=11.94, 95% CI=1,02-139,1); and 6,90 (OR=6.9, 95%CI=1,5-32,0 )times more likely to stay longer than those with nutritional status stayed normal during hospitalitation. They also had 3,3; unlimited; and 1,76 times risk on higher hospital charges than reference group (95% CI=1,123-9,529; unlimited; and 0,590-5,245).
Conclusion : The declines of nutritional status from normally to moderately, normally to severely, and moderately to severely malnourished in hospitalized patients influenced to longer length of stay. Normally to moderately and normally to severely malnourished in hospitalized patients influenced to higher hospital charges.

Key words : hospital malnutrition, length of stay, hospital charges

1 Korespondensi : Program Studi S1 Gizi Kesehatan, FK UGM, Yogyakarta

2Magister Gizi dan Kesehatan, IKM, Pascasarjana UGM, Yogyakarta


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PENGARUH PENGGUNAAN MODIFIKASI STANDAR RESEP LAUK NABATI TEMPE TERHADAP DAYA TERIMA DAN PERSEPSI PASIEN RAWAT INAP

Dewi Renaningtyas1, Endy Paryanto Prawirohartono2,Susetyowati2

ABSTRACT

Background
: Food management is inseparable part of all efforts to cure hospitalized patients. If patient is not able to consume enough food, nutrient deficiency will occur. This condition results in delayed recovery of illness, lengthen length of stay, therefore hospital charges will increase. According to previous observations, there is a significant plate waste due to several reasons. To minimize the negative effect of plate waste on diet therapy, standard of recipes should be applied.
Objective : To analyze the influence of the modification of recipes standard of fermented soybean on patient’s acceptance and perception.
Method : We conducted a cross-over design study in Dr. Sardjito Hospital Yogyakarta. The subjects were adults patients who admitted to the Departments of Surgery and Obstetrics and Gynecology. The inclusion criteria were hospitalized more than 4 days, over 15 years old, not in severe illness, got ordinary diet, and signed an informed consent. The food acceptance was measured as plate waste that was weighed using a special scale with accuracy of 10 grams. Food perceptions were measured using a questionnaire. Data were analyzed using chi-square test and Spearman correlation test.
Result : Among 132 patients, 112 (84,8%) patients had good acceptance to the modified recipes compared to 20 (15,2%) patients who had poor acceptance, whereas only 66 (50%) patients from standard recipes had good acceptance to standard recipes, and this difference was statistically significant (p=0,006). There were 99 (75%)patients from modified recipes who had good perceptions to modified recipes compared to 18 (13,6%) patients from standard recipes who had good perceptions to standard recipes, and this difference statistically significant (p=0,003).
Conclusion : Patients from surgery and obstetric and gynecology wards prefer modified recipes of fermented soybean compared to standard recipes.

Key words : fermented soybean, acceptance, perception, hospitalized patients

1 Korespondensi : SMK Muhammadiyah 4 Diknas Kota Yogyakarta
2RS Dr. Sardjito Yogyakarta

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PENGARUH ASUPAN MAKANAN TERHADAP KEJADIAN MALNUTRISI DI RUMAH SAKIT

Defriani Dwiyanti1, Hamam Hadi2, Susetyowati3

ABSTRACT

Background
: Sufficient food and other nutrient intake are necessary for recovery of hospitalized patients. Insufficient food intake may decrease nutrient metabolism, which in turn may cause malnutrition. Malnutrition in all hospital is categorized as high (about 40-45%). However,the influence of food intake on hospital malnutrition in Indonesia is still unknown.
Objective : To assess the influence of nutrient intake on the occurence of hospital malnutrition.
Method : This was an observational with prospective cohort study. This study was conducted in Dr. M. Jamil Padang Hospital, Dr. Sardjito Yogyakarta Hospital, and Sanglah Denpasar Hospital. Subjects were 228 adult patients from internal and neurology units in 1st, 2nd, and 3rd class who were hospitalized for six days or more, receiving oral diet, compos mentis, cooperative, non edema, and non ascites. Data of body weight and body height were measured at admission and discharge. Food intake data collected in this study included hospital and non-hospital food. Data analyzed by FP2 programme and STATA software.
Result : Among 228 subjects of study, 51,8% had insufficient intake in the first three days of hospitalization. On average, their protein and energy intakes were lower than subjects with sufficient intake. There was a significant correlation between the first three days intake and intake during hospitalization (p<0,05). Subjects with insufficient energy intake were 2,1 times more likely to be malnourished in hospital than subjects with sufficient energy intake. Meanwhile, subjects with insufficient protein intake were 1,56 times more likely to be malnourished than subjects with sufficient protein intake. There was a significant association between energy intake and hospital malnutrition (p<0,05).
Conclusion : Patients with insufficient nutrient intakes are more likely to be malnourished than those with sufficient nutrient intakes.

Key words : food intake, hospital malnutrition,hospitalized patients.

1 Korespondensi : Jurusan Gizi Poltekes Padang
2 Magister Gizi dan Kesehatan, IKM, Pascasarjana UGM, Yogyakarta
3 Instalasi Gizi RS Dr. Sardjito, Yogyakarta

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FAKTOR-FAKTOR YANG MEMPENGARUHI KEJADIAN MALNUTRISI PASIEN DEWASA DI RUANG RAWAT INAP RUMAHSAKIT

I G A Kusumayanti1, Hamam Hadi2, Susetyowati3

ABSTRACT

Background
: Nutrient intakes may influence nutritional status of patients during health care. It was reported that nutritional status of 75% of hospitalized patients declined during hospitalization.
Objective : The objectives of this study was to assess factors that may influence malnutrition among adult patients in hospital.
Method : This study was done using a nested case control study design. Subjects were inpatients of internal and neurology departments of Sanglah, Sardjito and M. Jamil hospitals. They were all given oral feeding, in consciousness condition, cooperative, and non-ascites. Data on food consumption were obtained using comstock methods, while nutritional status were measured using Subjective Global Assessment.
Result : Low energy intake, length of stay, infection, and special diet were all associated with a higher risk of hospital malnutrition. Patients with low energy intakes were 2.4 (OR=2.4, 95%CI= 1.17-4.92) times more likely to be malnourished than those with sufficient energy intakes. Patients with length of stay >= 7 days were 8(OR=8.15, 95% CI =1.87-35.51) times more likely to be malnourished than those with length of stay < 7 days. Patients with infectious diseases were 3 (OR= 0.33, 95% CI= 0.17-0.64) times less likely to be malnourished than those with non infectious diseases. Lastly, patients with special diet were 2 (OR=1.96, 95% CI= 1.05-3.68) times more likely to be malnourished than those without special diet.
Conclusion : Low energy intake, length of stay, non infectious diseases, and special diet are risk factors of malnutrition in adult hospitalized patients.

Key words : Nutrients intake, nutritional status, hospital malnutrition.

1 Korespondensi : Jurusan Gizi Poltekes Denpasar, Bali
2 Magister Gizi dan Kesehatan, IKM, Pascasarjana UGM, Yogyakarta
3 Instalasi Gizi RS Dr. Sardjito, Yogyakarta

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HUBUNGAN ANTARA STATUS GIZI AWAL DENGAN STATUS PULANG DAN LAMA RAWAT INAP PASIEN DEWASA DI RUMAH SAKIT

Nurul Huda Syamsiatun1, Hamam Hadi2, Madarina Julia3

ABSTRACT

Background
: Hospital malnutrition is reported to be prevalent in Indonesia. Wether nutritional status at admission is associated with nutritional status at discharge and length of stay remains unclear.
Objective : To assess the association between nutritional status at the admission and nutritional status at discharge and length of stay in adult hospitalized patients.
Method : A total subjects of 293 adult patients who were admitted to internal and neurology departments of Dr. Sardjito, Dr.M.Jamil, and Sanglah hospitals were included in this study. Nutritional status of each patient was assessed using Body Mass Index (BMI ) measured at admission and on discharge. Information on length of stay and hospital charge was collected based on medical records.
Result : Low energy intake was associated with worse outcome (OR 1,2 95%CI 1,74-11,94). Non infection diseases were also found to be associated with worse outcome (OR 6,91 95%CI 4,03-11,85) and length of stay (OR 1,83 95%CI 1,10-3,05). Prehospitalized and class of hospitalized were associated with length of stay (OR 2,34 95%CI 1,36-8,57).
Conclusion : Low nutritional status on admission and low energy intake were associated with higher risk of worse outcome (OR 2,34 95%CI 1,05-5,24) and (OR 3,41 95%CI 1,36-8,57).

Key words : length of stay, discharge status, nutritional status at the admission

1 Korespondensi : Jurusan Gizi, Poltekes Yogyakarta
2 Magister Gizi dan Kesehatan, Pascasarjana UGM Yogyakarta
3 Bagian Anak RS Dr. Sardjito Yogyakarta

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HUBUNGAN ANTARA KADAR SERUM ALBUMIN AWAL DENGAN LAMA RAWAT INAP DAN STATUS PULANG PASIEN DEWASA DI RUMAH SAKIT

Weni Kurdanti1, Hamam Hadi2, M. Juffrie3

ABSTRACT

Background
: Several community studies have reported a relationship between a low serum albumin level and increased risk of hospital death, nosocomial infection, and length of stay. But this kind of study is still lacking in Indonesia.
Objective : To assess the relationship between admission serum albumin levels with length of stay and recovery rate among adult hospitalized patients.
Method : This cohort study was done in 2002. Subjects of this study were adults, inpatient of internal and neurological departments of Dr.Sardjito, Dr. M. Jamil and Sanglah hospitals. Serum albumin level, total lymphocyte count (TLC), and hemoglobin from each subject were collected at the admission. Energy intake of each subject was obtained using visual Comstock method. Information of length of stay and recovery status at discharge was obtained from medical records.
Result : On average the length of stay (LOS) in patients with normal serum albumin was 9.8 days. In patients with low serum albumin the LOS was 2 days longer (p<0.05) than that in patient with normal serum albumin. LOS was not significantly different by serum albumin levels among neurological and cancer patients. Neurological patients with low serum albumin had 10 times greater risk for not recover on discharge than non neurological patients with normal serum albumin.
Conclusion : Serum albumin level at admission was associated with LOS and recovery status on discharge.

Key words : length of stay, recovery, serum albumin

1 Korespondensi : Jurusan Gizi, Poltekes Yogyakarta
2 Magister Gizi dan Kesehatan, Pascasarjana UGM Yogyakarta
3 Bagian Anak RS Dr. Sardjito Yogyakarta
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