Faktor prediksi risiko terjadinya sepsis pasca bedah

NUGROHO, Justinus Ratrianto, Dr. Pandit Sarosa H., Sp.An.K

2007 | Tesis | PPDS I Anestesiologi dan Reanimasi

Penelitian ini bertujuan mengindentifikasi faktor risiko prabedah,intraoperatif dan periode awal pasca bedah untuk terjadinya sepsis pada yang menjalani pembedahan mayor guna mendapatkan penatalaksanan agresif yang berpengaruh pada hasil akhir. Empat puluh empat pasien yang menjalani operasi mayor, ASA I-III usia lebih dari 18 tahun.dengan anestesi umum di Gedung Bedah Sentral Terpadu (GBST) RS DR.Sardjito Yogyakarta selanjutnya diamati dalam perawatan ruang ICU. Pasien yang berkembang menjadi sepsis dalam kurun waktu 7 hari pasca bedah dikategorikan menjadi kelompok sepsis dan yang lainnya sebagai kelompok kontrol. Semua data didapatkan selama operasi (hari 0) dan hari 1 serta hari 2 pasca bedah. Hemodinamik diukur sebelum operasi dan selama operasi dengan interval 5 menit. Data status fisik meliputi ASA dan indeks Charlson co-morbidity didapat sebelum operasi. Data katagori dalam jumlah (%) dan data kualitatif dtampilkan dalam rata-rata (SD). Olah data dengan program SPSS, dimana analisis univariate digunakan untuk menggambarkan faktor risiko terjadinya sepsis. X2 tests atau Fischer’s exact test digunakan untuk variabel kuantitatif. Level siginifikansi ditentukan, bila P<0,05 dinyatakan statistik bermakna dan ditentukan dengan interval kepercayaan 95 % Analisis multivariate digunakan untuk menentukan peran berurutan terjadinya sepsis pada masing-masing variabel.

The objective of this study is to know early identification preoperative, intraoperative and postoperative of high risk patient undergoing major surgery can result in an aggressive management sepsis affecting the outcome. Fourty-four patients each men and women, ASA physical status I-III (>18 years old), who were scheduled for elective major surgery with general anesthesia,and they were admitted to the ICU postoperatively.The patient who developed severe sepsis during the 7 days after surgery were allocated to the sepsis group and the others to control group. All data were collected during the intra-operative periode (day 0) and on day 1 and 2 after surgery. Hemodynamic variables are electronically recorded preoperatively and at 5 min intervals thoughout the surgery. The data required to evaluate the physical status as the Charlson co-morbidity indeks, ASA physical status were recorded preoperatively. Cathagorical data are presented as number (%). Quantitative data are presented as mean +(SD). Statistical analysis was performed using SPSS software. Univariate analysis was conducted to determine potencial risk factor for occurrence of sepsis. X2 tests or Fischer’s exact test were used for qualitative variables. A multivariate analysis was used to quantify the respective role of each variable on the occurrence of sepsis. P value of <0.05 is considered statistically significance and determined by 95 % confident interval

Kata Kunci : Sepsis Pasca Bedah,Komplikasi,Pasca Bedah Mayor, complications,postoperative sepsis;predictors;mayor surgery