Skor CALL-K untuk Memprediksi Kematian pada Pasien Syok Kardiogenik karena Infark Miokard Akut

Muhammad Ali Mukti, dr. Hendry Purnasidha Bagaswoto, Sp.JP(K), dr. Hasanah Mumpuni, Sp.PD(K)., Sp.JP(K)

2023 | Tesis-Spesialis | ILMU PENYAKIT JANTUNG DAN PEMBULUH DARAH

Latar Belakang: Angka kematian pasien syok kardiogenik karena infark miokard akut (IMA) masih tinggi. Renal replacement therapy (RRT) diperlukan dalam penatalaksanaan syok kardiogenik. Skor CALL-K adalah skor risiko pertama yang dapat memprediksi risiko kebutuhan RRT pada pasien syok kardiogenik. Semakin tinggi skor CALL-K, semakin tinggi kebutuhan RRT dan semakin tinggi juga angka kematian. Skor untuk memprediksi kematian pada kondisi syok kardiogenik khususnya karena IMA belum ada.

Tujuan Penelitian: Mengetahui peran skor CALL-K dalam memprediksi kematian pada pasien syok kardiogenik karena infark miokard akut di RSUP Dr. Sardjito.

Metode Penelitian: Penelitian ini merupakan studi observasional analitik dengan desain kohort retrospektif. Penelitian ini dilakukan pada pasien syok kardiogenik karena IMA di RSUP Dr. Sardjito Yogyakarta periode Januari 2022-Desember 2022.

Hasil: Terdapat 146 pasien yang memenuhi kriteria inklusi dan eksklusi, dengan 63 subjek (43,1%) mengalami kematian. Sebanyak 76%(n=111) subjek merupakan laki-laki. Rerata usia subjek penelitian 61 ± 11.7 tahun. Berdasarkan analisis multivariat, skor CALL-K (OR 3,02, IK95% 1,19-7,67, p=0,02), klasifikasi SCAI D syok kardiogenik (OR 17,49, IK95% 2,53-120,98, p<0 p=0,04), p=0,02),>0,05).

Simpulan: Skor CALL-K bukan variabel independent sebagai prediktor kematian pada pasien syok kardiogenik karena infark miokard akut.

Background: The mortality rate among patients with cardiogenic shock due to acute myocardial infarction (AMI) remains high. Renal replacement therapy (RRT) is necessary in managing cardiogenic shock. CALL-K score is the first risk score that can predict the risk of requiring RRT in patients with cardiogenic shock. The higher CALL-K score, higher need for RRT and higher the mortality rate. However, there is no existing score to predict mortality specifically in cardiogenic shock conditions, especially due to AMI.

Objective: To determine the role of CALL-K score in predicting mortality in patients with cardiogenic shock due to AMI at Dr. Sardjito General Hospital.

Methods: The study was an analytical observational study with a retrospective cohort design. It was conducted on patients with cardiogenic shock due to AMI at Dr. Sardjito General Hospital, Yogyakarta, from January 2022 to December 2022.

Results: There were 146 patients who met the inclusion and exclusion criteria, with 63 subjects (43.1%) experiencing mortality. Of these, 76% (n=111) were male. The mean age of the subjects was 61 ± 11.7 years. Multivariate analysis revealed that the CALL-K score (OR 3.02, 95% CI 1.19-7.67, p=0.02), SCAI D classification of cardiogenic shock (OR 17.49, 95% CI 2.53-120.98, p<0 p=0.04), p=0.02),>0.05).

Conclusion: CALL-K score is not an independent variable as a predictor of mortality in patients with cardiogenic shock due to acute myocardial infarction.

Kata Kunci : infark miokard akut, syok kardiogenik, skor CALL-K, kematian