IDENTIFIKASI RISIKO TINGGI KEMATIAN PADA PASIEN SEPSIS DI INSTALASI GAWAT DARURAT RUMAH SAKIT SWASTA BANDUNG
Abstract
Pendahuluan: Jumlah pasien di IGD Rumah sakit swasta selama periode November 2021 – November 2022 ada 24.010 pasien. Dari jumlah tersebut, terdapat 192 kematian, dan 80 diantaranya meninggal saat penanganan di IGD, sedangkan jumlah kematian pasien yang mengalami sepsis sebanyak 27 orang.
Tujuan: Penelitian ini bertujuan untuk mengetahui risiko tinggi kematian pasien yang mengalami sepsis di IGD. Penelitian ini menggunakan desain deskriptif kuantitatif melalui pendekatan longitudinal studi secara retrospektif, dengan daftar tilik elektronik terhadap penilaian qSOFA sebagai instrumen pengumpulan data. Sampel penelitian didapatkan 175 rekam medik pasien yang mengalami sepsis di IGD berdasarkan penilaian SIRS yang dipilih menggunakan teknik purposive sampling.
Hasil: Hasil penelitian didapatkan 104 (50,9%) responden berisiko tinggi mengalami kematian dengan skor ≥ 2 pada penilaian qSOFA dengan jumlah kematian pada pasien berisiko tinggi sebanyak 27 (25,96%). Frekuensi pernapasan ≥ 22 kali/menit sebanyak 137 (78,3%) responden, score GCS < 15 sebanyak 99 (56,6%) responden, dan tekanan darah sistolik > 100 mmHg sebanyak 123 (70,3%) responden.
Kesimpulan: Berdasarkan hasil penelitian, qSOFA dapat direkomendasikan sebagai instrumen tambahan dalam mengidentifikasi risiko tinggi kematian pada pasien sepsis IGD.
References
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Evans, T. (2018). Diagnosis and Management of Sepsis. 18(2), 146–149. https://doi.org/10.7861%2Fclinmedicine.18-2-146
Fleischmann, C., Scherag, A., Adhikari, N. K. J., Hartog, C. S., Tsaganos, T., Schlattmann, P., Angus, D. C., & Reinhart, K. (2016). Assessment of global incidence and mortality of hospital-treated sepsis current estimates and limitations. American Journal of Respiratory and Critical Care Medicine, 193(3), 259–272. https://doi.org/10.1164/rccm.201504-0781OC
Freund, Y., Lemachatti, N., Krastinova, E., Van Laer, M., Claessens, Y. E., Avondo, A., Occelli, C., Feral-Pierssens, A. L., Truchot, J., Ortega, M., Carneiro, B., Pernet, J., Claret, P. G., Dami, F., Bloom, B., Riou, B., & Beaune, S. (2017). Prognostic accuracy of sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA - Journal of the American Medical Association, 317(3), 301–308. https://doi.org/10.1001/jama.2016.20329
Irawan, E., Medison, I., Anggraini, F., & Mizarti, D. (2020). Sepsis Et Causa Empiema Dekstra Et Causa Community Acquired Pneumonia Dengan Komorbid Diabetes Melitus. Jurnal Kedokteran YARSI, 28(2), 001–013. https://doi.org/10.33476/jky.v28i2.1418
Iskandar, A., & Siska, F. (2020). Analisis Hubungan Sequential Organ Failure Assessment (Sofa) Score Dengan Mortalitas Pasien Sepsis. Jurnal Kesehatan Andalas, 9(2), 168. https://doi.org/10.25077/jka.v9i2.1221
Kakihana, Y., Ito, T., Nakahara, M., Yamaguchi, K., & Yasuda, T. (2016). Sepsis-induced myocardial dysfunction: Pathophysiology and management. Journal of Intensive Care, 4(1), 1–10. https://doi.org/10.1186/s40560-016-0148-1
Mahdian, M., Fazel, M. R., Fakharian, E., Akbari, H., & Mahdian, S. (2014). Cerebral state index versus Glasgow coma scale as a predictor for in-hospital mortality in brain-injured patients. Chinese Journal of Traumatology - English Edition, 17(4), 220–224. https://doi.org/10.3760/cma.j.issn.1008-1275.2014.04.007
Marbun, A. S., Sinuraya, E., Amila, A., & Simanjuntak, G. V. (2020). Glasgow Coma Scale (GCS) dan Tekanan Darah Sistolik Sebagai Prediktor Outcome Pasien Cedera Kepala. Bali Medika Jurnal, 7(2), 146–153. https://doi.org/10.36376/bmj.v7i2.140
Mirawati, A., Deswita, D., & Solok Poltekkes Kemenkes Padang, K. (2022). Efektivitas Early Warning System Score dalam Pencegahan Perburukan Pasien di Rumah Sakit. Jurnal Kesehatan Lentera ’Aisyiyah, 5(1), 568–576. https://backup.politasumbar.ac.id/index.php/jl/article/view/125
Mukhlisin, R., Saragih, S. G. R., Natalia, D., Parasit, D., Kedokteran, P. S., & Untan, F. K. (2018). Hubungan antara Quick Sequential Organ Failure Assessment Score dan Angka Mortalitas pada Pasien Cedera Kepala SMF Bedah Saraf , RS Abdul Aziz Singkawang Cedera kepala merupakan keadaan orang , tahun 2014 sebanyak 550 dan tahun 2015 sebanyak 470 orang . D. 4, 667–676.
Napolitano, L. M. (2018). Sepsis 2018: Definitions and Guideline Changes. Surgical Infections, 19(2), 117–125. https://doi.org/10.1089/sur.2017.278
Rhee, C., & Klompas, M. (2017). New Sepsis and Septic Shock Definitions: Clinical Implications and Controversies. Infectious Disease Clinics of North America, 31(3), 397–413. https://doi.org/10.1016/j.idc.2017.05.001
Singer, A. J., Ng, J., Thode, H. C., Spiegel, R., & Weingart, S. (2017). Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection. Annals of Emergency Medicine, 69(4), 475–479. https://doi.org/10.1016/j.annemergmed.2016.10.007
Singer, M., Deutschman, C. S., Seymour, C., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J. D., Coopersmith, C. M., Hotchkiss, R. S., Levy, M. M., Marshall, J. C., Martin, G. S., Opal, S. M., Rubenfeld, G. D., Poll, T. Der, Vincent, J. L., & Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - Journal of the American Medical Association, 315(8), 801–810. https://doi.org/10.1001/jama.2016.0287
Singh, G., Winardi, M., & Rumende, C. M. (2014). Profil Klinis dan Luaran Pasien Gawat Darurat Medis Dewasa di Rumah Sakit Cipto Mangunkusumo, Jakarta. Indonesian Journal of Chest Critical and Emergency Medicine, 1(3), 108–112.
Sis Indrawanto, I. (2017). Sindroma Hiperventilasi. Saintika Medika, 11(2), 78. https://doi.org/10.22219/sm.v11i2.4201
Sumarno, S., Hidajat, M., & Rini, I. S. (2016). Glasgow Coma Scale (Gcs), Tekanan Darah Dan Kadar Hemoglobin Sebagai Prediktor Kematianpada Pasien Cedera Kepala. Jurnal Ilmiah Kesehatan Keperawatan, 12(3), 132–143. https://doi.org/10.26753/jikk.v12i3.162
Tambajong, R. N., Lalenoh, D. C., & Kumaat, L. (2016). Profil penderita sepsis di ICU RSUP Prof . Dr . R . D . Kandou Bagian Anestesi dan Reanimasi Fakultas Kedokteran Pada tahun 1991 , American College of Chest Physicians and Society of Critical Care Medicine mengadakan konferensi seragam tentang sepsis dan. 4(November 2015).
Vincent, J. L., Marshall, J. C., Ñamendys-Silva, S. A., François, B., Martin-Loeches, I., Lipman, J., Reinhart, K., Antonelli, M., Pickkers, P., Njimi, H., Jimenez, E., Sakr, Y., Tomas, E., Bibonge, E. A., Charra, B., Faroudy, M., Doedens, L., Farina, Z., Adler, D., … Brealey, D. (2014). Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations (ICON) audit. The Lancet Respiratory Medicine, 2(5), 380–386. https://doi.org/10.1016/S2213-2600(14)70061-X
Widjaya, N., Anwar, F., Laura Sabrina, R., Rizki Puspadewi, R., & Wijayanti, E. (2019). Hubungan Usia Dengan Kejadian Hipertensi di Kecamatan Kresek dan Tegal Angus, Kabupaten Tangerang. YARSI Medical Journal, 26(3), 131. https://doi.org/10.33476/jky.v26i3.756
Wungo, J. A., Widyastuti, C. S., & Rina Setyan, F. A. (2022). Faktor-Faktor Yang Berhubungan Dengan Mortalitas Pasien Di Intensive Care Unit Rumah Sakit Panti Rapih Yogyakarta. I Care Jurnal Keperawatan STIKes Panti Rapih, 3(2), 168–179. https://doi.org/10.46668/jurkes.v3i2.176
Zhou, H., Lan, T., & Guo, S. (2020). Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department. Emergency Medicine International, 2020, 1–11. https://doi.org/10.1155/2020/7979353
Aryabiantara, I. W., Wiryana, M., Sinardja, K., Agung Senapathi, T. G., Widnyana, I. M. G., Surya Panji, P. A., Sukrana Sidemen, I. G. P., & Pradhana, A. P. (2017). Comparative Validity Sequential Scoring System Organ Failure Assesment (SOFA) and Quick - Sequential Organ Failure Assesment (qSOFA) on Estimating Mortality for Patients Treated in the Intensive Care Unit of Sanglah General Hospital. Journal of Aging Science, 08(05). https://doi.org/10.4172/2155-6148.1000726
Donnelly, J. P., Safford, M. M., Shapiro, N. I., Baddley, J. W., & Wang, H. E. (2017). Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study. The Lancet Infectious Diseases, 17(6), 661–670. https://doi.org/10.1016/S1473-3099(17)30117-2
Evans, T. (2018). Diagnosis and Management of Sepsis. 18(2), 146–149. https://doi.org/10.7861%2Fclinmedicine.18-2-146
Fleischmann, C., Scherag, A., Adhikari, N. K. J., Hartog, C. S., Tsaganos, T., Schlattmann, P., Angus, D. C., & Reinhart, K. (2016). Assessment of global incidence and mortality of hospital-treated sepsis current estimates and limitations. American Journal of Respiratory and Critical Care Medicine, 193(3), 259–272. https://doi.org/10.1164/rccm.201504-0781OC
Freund, Y., Lemachatti, N., Krastinova, E., Van Laer, M., Claessens, Y. E., Avondo, A., Occelli, C., Feral-Pierssens, A. L., Truchot, J., Ortega, M., Carneiro, B., Pernet, J., Claret, P. G., Dami, F., Bloom, B., Riou, B., & Beaune, S. (2017). Prognostic accuracy of sepsis-3 criteria for in-hospital mortality among patients with suspected infection presenting to the emergency department. JAMA - Journal of the American Medical Association, 317(3), 301–308. https://doi.org/10.1001/jama.2016.20329
Irawan, E., Medison, I., Anggraini, F., & Mizarti, D. (2020). Sepsis Et Causa Empiema Dekstra Et Causa Community Acquired Pneumonia Dengan Komorbid Diabetes Melitus. Jurnal Kedokteran YARSI, 28(2), 001–013. https://doi.org/10.33476/jky.v28i2.1418
Iskandar, A., & Siska, F. (2020). Analisis Hubungan Sequential Organ Failure Assessment (Sofa) Score Dengan Mortalitas Pasien Sepsis. Jurnal Kesehatan Andalas, 9(2), 168. https://doi.org/10.25077/jka.v9i2.1221
Kakihana, Y., Ito, T., Nakahara, M., Yamaguchi, K., & Yasuda, T. (2016). Sepsis-induced myocardial dysfunction: Pathophysiology and management. Journal of Intensive Care, 4(1), 1–10. https://doi.org/10.1186/s40560-016-0148-1
Mahdian, M., Fazel, M. R., Fakharian, E., Akbari, H., & Mahdian, S. (2014). Cerebral state index versus Glasgow coma scale as a predictor for in-hospital mortality in brain-injured patients. Chinese Journal of Traumatology - English Edition, 17(4), 220–224. https://doi.org/10.3760/cma.j.issn.1008-1275.2014.04.007
Marbun, A. S., Sinuraya, E., Amila, A., & Simanjuntak, G. V. (2020). Glasgow Coma Scale (GCS) dan Tekanan Darah Sistolik Sebagai Prediktor Outcome Pasien Cedera Kepala. Bali Medika Jurnal, 7(2), 146–153. https://doi.org/10.36376/bmj.v7i2.140
Mirawati, A., Deswita, D., & Solok Poltekkes Kemenkes Padang, K. (2022). Efektivitas Early Warning System Score dalam Pencegahan Perburukan Pasien di Rumah Sakit. Jurnal Kesehatan Lentera ’Aisyiyah, 5(1), 568–576. https://backup.politasumbar.ac.id/index.php/jl/article/view/125
Mukhlisin, R., Saragih, S. G. R., Natalia, D., Parasit, D., Kedokteran, P. S., & Untan, F. K. (2018). Hubungan antara Quick Sequential Organ Failure Assessment Score dan Angka Mortalitas pada Pasien Cedera Kepala SMF Bedah Saraf , RS Abdul Aziz Singkawang Cedera kepala merupakan keadaan orang , tahun 2014 sebanyak 550 dan tahun 2015 sebanyak 470 orang . D. 4, 667–676.
Napolitano, L. M. (2018). Sepsis 2018: Definitions and Guideline Changes. Surgical Infections, 19(2), 117–125. https://doi.org/10.1089/sur.2017.278
Rhee, C., & Klompas, M. (2017). New Sepsis and Septic Shock Definitions: Clinical Implications and Controversies. Infectious Disease Clinics of North America, 31(3), 397–413. https://doi.org/10.1016/j.idc.2017.05.001
Singer, A. J., Ng, J., Thode, H. C., Spiegel, R., & Weingart, S. (2017). Quick SOFA Scores Predict Mortality in Adult Emergency Department Patients With and Without Suspected Infection. Annals of Emergency Medicine, 69(4), 475–479. https://doi.org/10.1016/j.annemergmed.2016.10.007
Singer, M., Deutschman, C. S., Seymour, C., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J. D., Coopersmith, C. M., Hotchkiss, R. S., Levy, M. M., Marshall, J. C., Martin, G. S., Opal, S. M., Rubenfeld, G. D., Poll, T. Der, Vincent, J. L., & Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - Journal of the American Medical Association, 315(8), 801–810. https://doi.org/10.1001/jama.2016.0287
Singh, G., Winardi, M., & Rumende, C. M. (2014). Profil Klinis dan Luaran Pasien Gawat Darurat Medis Dewasa di Rumah Sakit Cipto Mangunkusumo, Jakarta. Indonesian Journal of Chest Critical and Emergency Medicine, 1(3), 108–112.
Sis Indrawanto, I. (2017). Sindroma Hiperventilasi. Saintika Medika, 11(2), 78. https://doi.org/10.22219/sm.v11i2.4201
Sumarno, S., Hidajat, M., & Rini, I. S. (2016). Glasgow Coma Scale (Gcs), Tekanan Darah Dan Kadar Hemoglobin Sebagai Prediktor Kematianpada Pasien Cedera Kepala. Jurnal Ilmiah Kesehatan Keperawatan, 12(3), 132–143. https://doi.org/10.26753/jikk.v12i3.162
Tambajong, R. N., Lalenoh, D. C., & Kumaat, L. (2016). Profil penderita sepsis di ICU RSUP Prof . Dr . R . D . Kandou Bagian Anestesi dan Reanimasi Fakultas Kedokteran Pada tahun 1991 , American College of Chest Physicians and Society of Critical Care Medicine mengadakan konferensi seragam tentang sepsis dan. 4(November 2015).
Vincent, J. L., Marshall, J. C., Ñamendys-Silva, S. A., François, B., Martin-Loeches, I., Lipman, J., Reinhart, K., Antonelli, M., Pickkers, P., Njimi, H., Jimenez, E., Sakr, Y., Tomas, E., Bibonge, E. A., Charra, B., Faroudy, M., Doedens, L., Farina, Z., Adler, D., … Brealey, D. (2014). Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations (ICON) audit. The Lancet Respiratory Medicine, 2(5), 380–386. https://doi.org/10.1016/S2213-2600(14)70061-X
Widjaya, N., Anwar, F., Laura Sabrina, R., Rizki Puspadewi, R., & Wijayanti, E. (2019). Hubungan Usia Dengan Kejadian Hipertensi di Kecamatan Kresek dan Tegal Angus, Kabupaten Tangerang. YARSI Medical Journal, 26(3), 131. https://doi.org/10.33476/jky.v26i3.756
Wungo, J. A., Widyastuti, C. S., & Rina Setyan, F. A. (2022). Faktor-Faktor Yang Berhubungan Dengan Mortalitas Pasien Di Intensive Care Unit Rumah Sakit Panti Rapih Yogyakarta. I Care Jurnal Keperawatan STIKes Panti Rapih, 3(2), 168–179. https://doi.org/10.46668/jurkes.v3i2.176
Zhou, H., Lan, T., & Guo, S. (2020). Prognostic Prediction Value of qSOFA, SOFA, and Admission Lactate in Septic Patients with Community-Acquired Pneumonia in Emergency Department. Emergency Medicine International, 2020, 1–11. https://doi.org/10.1155/2020/7979353
Published
2023-08-31
Section
Articles
