Page 52 - Abstract Book KONIKA 18

Cardiology

O-CAR-005
Long-term Outcomes and Predictors of Mortality of Rheumatic Heart Disease in
Indonesian Children: A Single Center Experience

Nadya Arafuri, Indah Kartika Murni, Madarina Julia, Sasmito Nugroho, Noormanto
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/
Dr. Sardjito Hospital, Yogyakarta, Central Java, Indonesia

Abstract
Background Rheumatic heart disease (RHD) remains a preventable cause of cardiovascular deaths in
children in developing countries. However, outcome data of children with RHD is still lacking in Indonesia.
Objective To investigate the long-tem outcomes of RHD, particularly the survival rates and the predictors
Methods A retrospective cohort study was done in children aged less than 18 years old admitted with RHD
at a tertiary hospital (Dr. Sardjito Hospital, Yogyakarta, Indonesia) from 2011-2021. Survival time was
estimated from the date of first diagnosis of RHD to the survival endpoint (date of mortality or censoring).
Kaplan-Meier curves, log-rank test and Cox-regression analysis were used for survival analysis and the
predictors. Results A total of 155 patients admitted with RHD from 2011-2021. Of these, 13 (8.7%) deaths
were reported as RHD related mortality with the mean age of 11.9 (SD 2.9) years. Median follow up period
was 16 months. The survival rate at 1, 4 and 8 years were 93.6%, 86.7% and 60.1%, respectively. Survival
was lower in patients with severe valve lesions and NYHA functional class III-IV at the time of diagnosis.
Cox-regression analysis showed the significant predictor for mortality was poor adherence to penicillin (HR
22.1; 95%CI 2.1 to 227.5). Conclusion Approximately, only six of ten children will be able to survive at eight
years after diagnosis. Poor adherence to penicillin is a major predictor for deaths. This study emphasizes the
needs to improve the adherence of children with RHD.
Keywords: rheumatic heart disease; outcomes; children, mortality

O-CAR-006
Factors Associated to Clinical Outcomes of Pneumonia in Children Under-five
with Congenital Heart Disease at Third Level Hospital

Ricco Azali, Didik Haryanto, Finny Fitry Yani
Department of Child Health, Faculty of Medicine Universitas Andalas/Dr. M. Djamil General Hospital,
Padang, West SUmatera, Indonesia

Abstract
Background Pneumonia is the most common severe infection that leads to more severe symptoms in children
under-five with congenital heart disease. Objective This study aims to obtain the factors related to clinical
outcomes of pneumonia in children under-five with congenital heart disease. Methods A retrospective study
was conducted in Dr. M. Djamil General Hospital in Padang, Indonesia from medical record data for 3 years
(2018-2020) from all pneumonia children under-five with congenital heart disease. Clinical data obtained
includes age, parental education, birth weight, nutritional status, immunization history, types of congenital
heart disease, and leukocyte count. Results In 3 years, almost 90% of 65 children under-five with congenital
heart disease have been hospitalized with severe pneumonia. Risk of pneumonia were significantly higher in
children under-five with cyanotic congenital heart disease (100% vs. 77.8%; P= 0.004). The others factors:
father education, mother education, low birth weight (6.7% vs. 10%; P= 1.0), nutritional status (8.9% vs. 10%;
P=1.0), history of complete DPT (14.3% vs. 7.8%; P=0.6) & measles (11.8% vs. 0%; P= 0,3) vaccine, and
leucocyte count (18.8% vs. 9.1%; P= 0.3) were not associated with higher risk of pneumonia nor mortality in
this study. Conclusion Cyanotic congenital heart disease is one of the risk factors of pneumonia in children
with congenital heart disease.
Keywords: congenital heart disease; pneumonia; children under-five

6 KONIKA XVIII Abstract Book