Faktor Risiko Gangguan Kognitif Pasca Perawatan ICU di RSUP Dr. Sardjito

Dian Ayu Listiarini, Dr. dr. Yusmein Uyun, SpAn-TI, Subsp.An.O(K.; dr. Calcarina Fitriani Retno Wisudarti, SpAn-TI, Subps.An.TI(K)

2025 | Tesis-Subspesialis | SUBSPESIALIS ANESTESIOLOGI DAN TERAPI INTENSIF

Latar Belakang: Kemajuan teknologi di Intensive Care Unit (ICU) telah meningkatkan kelangsungan hidup pada pasien kritis, namun, memiliki dampak jangka panjang, salah satunya gangguan kognitif yang termasuk dalam domain Post Intensive Care Syndrome (PICS). Gangguan ini mencakup gangguan memori, fungsi eksekutif, bahasa, atensi dan visuospasial yang dapat mempengaruhi aktivitas harian dan kualitas hidup pasien.

Tujuan: mengetahui prevalensi dan faktor risiko gangguan kognitif pasca perawatan di ICU RSUP Dr. Sardjito.

Metode: Penelitian ini merupakan penelitian kohort prospektif dengan 89 pasien dewasa yang dirawat di ICU. Penilaian fungsi kognitif dilakukan 14 hari setelah keluar dari ICU dengan menggunakan Telephone Montreal Cognitive Assessment (T-MoCA). Analisis data dilakukan secara bivariat dan multivariat dengan uji regresi logistik.

Hasil: Prevalensi gangguan kognitif pasca perawatan ICU sebesar 57,3%. Analisis bivariat menunjukkan lama rawat ICU, durasi ventilasi mekanik, dukungan kardiovaskular, SAPS- 3, dan delirium berhubungan signifikan dengan gangguan kognitif pasca perawatan ICU. Analisis multivariat didapatkan LOS ICU (p=0,027; OR=1,78; 95% CI: 1,069–2,959) dan skor SAPS-3 (p=0,034; OR=1,053; 95% CI: 1,004–1,105) sebagai faktor risiko independen.

Kesimpulan: Lama rawat ICU (LOS ICU) dan skor SAPS-3 merupakan faktor risiko independen yang berpengaruh signifikan terhadap gangguan kognitif pasca perawatan ICU.

Background: Recently, advanced technologies in the Intensive Care Unit (ICU) have significantly improved survival rates in critically ill patients, However, ICU care may have long-term consequences, including cognitive impairment, which is part of Post Intensive- Care Syndrome (PICS). Cognitive impairment includes deficits in memory, executive function, language, attention and visuospatial ability that can impact daily activities and quality of life.

Objective: To determine the prevalence and identify risk factors for cognitive impairment following ICU care at Dr. Sardjito General Hospital.

Methods: This prospective cohort study design involving 89 adult ICU patients. Cognitive function was assessed using the T-MoCA instrument 14 days after ICU discharge. Data were analysed using bivariate and multivariate logistic regression.

Results: The prevalence of post-ICU cognitive impairment was 57.3%. Bivariate analysis showed significant associations with ICU length of stay, duration of mechanical ventilation, cardiovascular support, SAPS-3 score, and delirium. Multivariate analysis identified ICU LOS (p=0.027; OR=1.78; 95% CI: 1.069–2.959) and SAPS-3 score (p=0.034; OR=1.053; 95% CI: 1.004–1.105) as independent risk factors.

Conclusion: Length of stay (LOS) ICU and SAPS-3 score were independent risk factors of post-ICU cognitive impairment.

Kata Kunci : Gangguan kognitif, lama rawat ICU, SAPS-3, ICU, PICS