Peran Modified Societa Italiana Di Medicina Interna (Simi) Score Dalam Prediktor Keparahan Pasien Coronavirus Disease-19 (Covid-19) Di Rsup Dr. Sardjito Yogyakarta

Hafidz Setyawati, dr. Rizka Humardewayanti, Sp.PD KPTI., Dr.dr. Probosuseno. Sp.PD., K.Ger. S.E., M.M

2024 | Tesis-Spesialis | S2 Ilmu Penyakit Dalam

Latar Belakang: Coronavirus Disease 2019 (COVID-19) merupakan penyakit baru yang terus mengalami peningkatan kasus. Infeksi COVID-19 menyebabkan gejala ringan sampai dengan Acute Respiratory Distress Syndrome (ARDS) yang memerlukan perawatan intensif. Saat ini diperlukan upaya untuk membantu dokter untuk melakukan triase yang efektif, alokasi sumber daya perawatan kesehatan, dan penggunaan perawatan intensif. Skor penilaian untuk memprediksi derajat keparahan COVID-19 mulai dikembangkan. Salah satu skor sederhana adalah Societa Italiana di Medicin Interna (SIMI) Score, dimana di Indonesia belum pernah dilakukan.

Tujuan: mengetahui Modified SIMI Score sebagai prediktor dalam menentukan keparahan pada pasien terkonfirmasi COVID-19.

Metode: Penelitian observasional dengan desain penelitian crossectional pada Januari-Desember 2021 dari rekam medis elektronik pasien didiagnosis COVID-19 yang memenuhi kriteria inklusi dan eksklusi. Modified SIMI Score dinilai saat admisi. Skor ?7 dinilai sebagai skor tinggi. Analisa statistik bivariat menggunakan uji Chi-Square dan menghitung OR (Odds Ratio) untuk mengetahui Modified SIMI Score terhadap prediksi keparahan pada pasien COVID-19 dilanjutkan uji analisis multivariat dengan Regresi Logistik untuk menilai variabel manakah yang paling bermakna secara statistik.

Hasil Penelitian: Sebanyak 390 pasien COVID-19 dengan median usia 60 tahun, laki-laki sebanyak 60,8%. Pada analisa bivariat didapatkan variabel yang bermakna secara statistic yaitu: Modified SIMI Score OR 2,66, Diabetes mellitus OR 9,31, dan Obese OR 1,88. Pada analisa multivariat didapatkan beberapa variabel yang memiliki pengaruh secara konsisten dan signifikan terhadap derajat keparahan COVID-19 yaitu Modified SIMI Score OR 2,21, Diabetes mellitus OR 7,71

Kesimpulan: Modified SIMI Score yang tinggi merupakan prediktor tingkat keparahan pada pasien COVID-19.

Background: Coronavirus Disease 2019 (COVID-19) is a novel disease that continues to experience increasing cases. COVID-19 infection causes mild to Acute Respiratory Distress Syndrome (ARDS) symptoms that require intensive care. Currently, efforts are needed to assist doctors in effective triage, allocation of healthcare resources, and utilization of intensive care. Assessment scores to predict the severity of COVID-19 are being developed. One simple score is the Societa Italiana di Medicina Interna (SIMI) Score, which has not been conducted in Indonesia.

Objective: To determine the Modified SIMI Score as a predictor of the severity of COVID-19 patients.

Method: An observational study with a cross-sectional research design from January to December 2021 using electronic medical records of patients diagnosed with COVID-19 who met the inclusion and exclusion criteria. A modified SIMI score was conducted during admission. A score more than and equal to 7 define as high SIMI. Bivariate statistical analysis was performed using the Chi-Square test and calculating the Odds Ratio (OR) to determine the association between the high Modified SIMI Score and the prediction of severity in COVID-19 patients, followed by multivariate analysis using Logistic Regression to assess which variables were most statistically significant.

Result: A total of 390 COVID-19 patients with a median age of 60 years, of whom 60.8% were male. In bivariate analysis, statistically significant variables were found to be: Modified SIMI Score OR 2.66, Diabetes mellitus OR 9.31, and Obesity OR 1.88. In multivariate analysis, several variables consistently significant influenced the severity of COVID-19, namely Modified SIMI Score OR 2.21, Diabetes mellitus OR 7.71.

Conclusion: A high Modified SIMI Score is a predictor of the severity level in COVID-19 patients.

Kata Kunci : COVID-19, Modified SIMI Score, COVID-19 Severity.