Hubungan Late Diagnosis dengan Luaran Status Gizi Pasien Penyakit Hirschsprung Pasca Pull-through

Annisa Saras Rachmawati, Prof. dr. Gunadi, Ph.D., Sp.BA., Subsp.DA(K); dr. Kristy Iskandar, M.Sc.,Ph.D., Sp.A. Subsp.Neuro.(K)

2026 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Penyakit Hirschsprung (HSCR) atau aganglionosis intestinalis merupakan kelainan kongenital pada kolon dengan karakteristik berupa hilangnya kemampuan peristaltik dan dilatasi usus karena tidak adanya sel ganglion intrinsik parasimpatis pada pleksus submukosa dan pleksus mienterikus. Late diagnosis penyakit HSCR dapat meningkatkan risiko gagal tumbuh, komplikasi, dan gejala klinis yang lebih parah. Belum terdapat penelitian terkait luaran status gizi dengan late diagnosis pasca pull-through sehingga diperlukan penelitian lebih lanjut. Tujuan: Mengetahui hubungan late diagnosis dengan luaran status gizi pasien HSCR pasca pull-through di RSUP Dr. Sardjito. Metode: Penelitian observasional analitik dengan desain kohort retrospektif yang dilakukan di RSUP Dr. Sardjito Yogyakarta. Sampel penelitian berjumlah 68 pasien HSCR pasca pull-through periode 2019-2024 yang memenuhi kriteria inklusi. Variabel bebas adalah waktu diagnosis (early ?12 bulan vs late >12 bulan) dan variabel terikat adalah luaran status gizi berdasarkan parameter WHO (WAZ, HAZ, WHZ). Analisis data menggunakan uji Chi-Square untuk analisis bivariat dan regresi logistik untuk analisis multivariat dengan tingkat kemaknaan ?=0,05. Kata kunci: Hirschsprung, pull-through, late diagnosis, luaran status gizi

Background: Hirschsprung's disease (HSCR), or intestinal aganglionosis, is a congenital colon disorder characterized by the absence of intrinsic parasympathetic ganglion cells in the submucosal and myenteric plexuses, leading to the loss of peristaltic function and intestinal dilation. A delayed diagnosis of HSCR can increase the risk of failure to thrive, complications, and more severe clinical manifestations. There remains a lack of research regarding the association between delayed diagnosis and nutritional status outcomes following a pull-through procedure, necessitating further investigation. Objective: To examine the relationship between delayed diagnosis and nutritional status outcomes in post-pull- through HSCR patients at RSUP Dr. Sardjito. Method: An analytical observational study using a retrospective cohort design was conducted at Dr. Sardjito General Hospital, Yogyakarta. The study sample comprised 68 post-pull-through HSCR patientsfrom the 2019–2024 period who met the inclusion criteria. The independent variable was timing of diagnosis (early: ?12 months vs. late: >12 months), and the dependent variable was nutritional status outcome based on WHO parameters (WAZ, HAZ, WHZ). Data analysis utilized the Chi-Square test for bivariate analysis and logistic regression for multivariate analysis, with a significance level of ?=0.05.

Kata Kunci : Kata kunci: Hirschsprung, pull-through, late diagnosis, luaran status gizi