Ikatan Dokter Anak Indonesia
Indonesian Pediatrics Society

Faktor Risiko pada Lama Rawat dan Luaran Pasien Perawatan di Unit Perawatan Intensif Anak RSUP Sanglah Denpasar

Silvia Sudarmadji, Dyah Kanya Wati, Lanang Sidiartha
Abstrak

Latar belakang. Penelitian yang menelaah hubungan faktor risiko jenis kelamin, usia, status gizi, pemakaian jenis terapi oksigen, dan pemberian sedini mungkin nutrisi enteral terhadap lama rawat dan luaran perawatan UPIA belum banyak dilakukan.
Tujuan. Menilai pengaruh faktor risiko jenis kelamin, usia, status gizi, pemakaian jenis terapi oksigen, pemberian nutrisi enteral dini terhadap lama rawat dan luaran mortalitas pasien.
Metode. Penelitian analitik observasional dengan rancang kohort prospektif dilakukan selama periode Mei sampai Juli 2015 terhadap 81 pasien usia 1 bulan sampai 12 tahun di rawat di UPIA RSUP Sanglah, Denpasar.
Hasil. Terdapat 59,3% pasien laki-laki, 65,4% berusia <5 tahun, berstatus gizi buruk 6,2%, pemakaian jenis terapi oksigen nasal kanula 51,9% dan 60,5% pemberian nutrisi enteral <48 jam. Faktor risiko status gizi dan pemakaian jenis terapi oksigen berbeda bermakna (p<0,05) terhadap lama perawatan UPIA. Usia <5 tahun (RR 2,818; IK95% 0,897-8,854), pemakaian jenis terapi oksigen (p<0,001), terutama jenis intubasi (RR 6,000; IK95% 2,775-12,972) dan pemberian nutrisi enteral ≥48 jam (RR 0,003; IK95% 1,406-7,830) merupakan faktor risiko terhadap luaran perawatan UPIA, tetapi hanya faktor risiko pengunaan terapi oksigen, terutama jenis intubasi berperan dan berisiko luaran meninggal 16,576 kali terhadap pasien (RR:16,576; IK95% 2,688-102,225).
Kesimpulan. Faktor risiko status gizi dan pemakaian alat oksigenasi memperpanjang durasi lama rawat. Usia <5 tahun, pemakaian alat oksigenasi, dan waktu asupan nutrisi ≥48 jam terbukti meningkatkan faktor risiko mortalitas. Sari Pediatri 2016; 17(6):455-62.

 

Risk Factors Related to Duration of stay and Mortality Outcome in Pediatric Intensive Care Unit of Sanglah Hospital, Denpasar, Bali, Indonesia

Background. Studies that examine association between various risk factors such as sex, age, nutritional status, oxygen therapy and enteral nutrition in relation with duration of stay and mortality outcome in pediatric intensive care unit are still rare.
Objective. This study is aims to identify the risk factors (sex, age, nutritional status, different types of oxygen therapy and enteral nutrition) affecting duration of stay and mortality outcome.
Methods. A prospective cohort study of 81 children admitted to Pediatric Intensive Care Unit Sanglah hospital, aged 1 month until 12 years from May to July 2015 was conducted.
Results. Based on characteristic data of study, there were 59.3% male, 65.4 % under 5 years old, 6,2% with severe malnutrition, 51.9% patients with nasal cannula and 60.5% with enteral nutrition less than 48 hours. Risk factors observed were nutritional status and patients that received oxygen therapy were associated with longer duration of stay (p<0.05). Several other risk factors that were related to mortality outcome were age under five years (RR 2.818; 95% CI 0.897-8.854), oxygen therapy (p<0,001) intubation type (RR 6.000; 95% CI 2.775-12.972) and enteral nutrition more than 48 hours (RR 0.003; 95% CI 1.406-7.830), however only risk factor that increase mortality outcome upto 16.57 times was oxygen therapy especially if it was given through intubation (RR 16.576; 95% CI 2.688-102.225) in PICU Sanglah hospital, Denpasar.
Conclusions. Nutritional status and oxygen therapy were associated with prolonged length of stay. Age under 5 years, oxygen therapy, and enteral nutritional more than 48 hours increase mortality outcome of patients. Sari Pediatri 2016; 17(6):455-62.

Kata kunci: length of stay, mortality outcome, risk factor


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