Faktor Prognosis Kesembuhan Gizi Buruk Pada Anak Usia 1- 59 Bulan

Farah Uma Mauhibah, Dr. dr. Neti Nurani, M.Kes, Sp. A(K).; Dr. dr. Titis Widowati, Sp. A(K)

2026 | Tesis | S2 Kedokteran Klinik

Latar belakang: Gizi buruk merupakan bentuk malnutrisi paling berat yang masih menjadi masalah kesehatan anak global dan nasional. Kesembuhan bervariasi antarpasien dan dipengaruhi banyak faktor klinis maupun tata laksana. Hal tersebut juga berpengaruh pada seberapa besar risiko infeksi berulang, lama rawat inap, serta angka morbiditas dan mortalitas. Identifikasi faktor prognosis diperlukan untuk menentukan intervensi dini dan meningkatkan keberhasilan terapi.

Tujuan: Mengidentifikasi dan menganalisis rerata waktu dan faktor prognosis kesembuhan gizi buruk pada anak usia 1-59 bulan.

Metode: Penelitian kohort retrospektif menggunakan data rekam medis pasien gizi buruk usia 1–59 bulan di RS Sardjito periode 2019-2023. Analisis kesembuhan dilakukan dengan Kaplan–Meier dan Cox Regression untuk menentukan faktor prognosis.

Hasil: Sebanyak 134 subyek diamati selama 26 minggu dan dianalisis. Median kesembuhan adalah 69 hari (IK95D,1-93,8). Analisis multivariat menunjukkan jenis perawatan dan jenis nutrisi berhubungan secara signifikan dengan kesembuhan. Anak rawat jalan sembuh lebih lambat dibandingkan dengan rawat inap (HR 0,45; IK 95% 0,27-0,74; p=0,002). Pemberian oral nutritional supplement (ONS) berhubungan dengan kesembuhan lebih cepat dibandingkan dengan F75/F100 (HR 2,09; IK 95% 1,001-4,40; p=0,049). Variabel usia, jenis kelamin, pneumonia, tuberkulosis, diare, hipoglikemia, edema, dan rute nutrisi tidak berhubungan bermakna.

Kesimpulan: Jenis perawatan dan jenis nutrisi merupakan faktor prognosis kesembuhan gizi buruk. Optimalisasi terapi nutrisi dan pemantauan intensif, terutama pada fase awal perawatan, penting untuk mempercepat pemulihan.

Background: Severe malnutrition remains a major global and national pediatric health problem. Recovery time varies widely among patients and is influenced by multiple clinical and therapeutic factors. This also affects the risk of recurrent infections, length of hospital stay, as well as morbidity and mortality rates. Identifying prognostic factors is essential to optimize early interventions and improve outcomes.

Objective: To identify and analyze median time and prognostic factors of recovery time among under five children with severe malnutrition.

Methods: A retrospective cohort study was conducted using medical records of children aged 1-59 months with severe malnutrition treated at Sardjito Hospital from 2019 to 2023. Recovery time was analyzed using Kaplan–Meier survival analysis and Cox Regression to identify prognostic factors.

Results: A total of 134 subjects were included and observed for 26 weeks. The median recovery time was 69 days (95% CI 44.1-93.8). Multivariate analysis showed that the type of care and type of nutrition were significantly associated with recovery time. Outpatients recovered more slowly than inpatients (HR 0,45; CI 95% 0,27-0,74; p=0,002). Oral nutritional supplements (ONS) were associated with faster recovery compared with F75/F100 (HR 2,09; CI 95% 1,001-4,40; p=0,049). Age, sex, pneumonia, tuberculosis, diarrhea, hypoglycemia, edema, and feeding route were not significantly associated with recovery time.

Conclusion: Type of care and nutritional therapy are prognostic factors of recovery in severe malnutrition. Optimizing nutritional management and intensive monitoring, particularly during early treatment phases, is crucial to accelerate recovery.

Kata Kunci : gizi buruk, kesembuhan, faktor prognosis, nutrisi, balita