Evaluasi status nutrisi secara antropometris pasien baru yang dirawat inap instalasi kesehaatn anak RSUP DR. Sardjito Yogyakarta

SURVIANA, dr. Neti Nurani, SpA.,M.Kes

2010 | Tesis | S2 Ilmu Kedokteran Klinik

Latar belakang Status gizi anak sering mengalami perubahan selama rawat inap, anak yang menderita sakit akan mengalami penurunan nafsu makan dan keterbatasan dalam mengkomsumsi makanan serta menunjukkan penurunan asupan kalori dan protein. Kejadian malnutrisi di rawat inap bagian anak, dengan dampak pada pertumbuhan, komplikasi penyakit, lamanya penyembuhan, bertambahnya lama hari rawat, beban biaya kesehatan, morbiditas dan mortalitas. Tujuan penelitian Mengetahui perubahan berat badan selama perawatan yang mengakibatkan perubahan status gizi pasien dan hubungan kejadian malnutrisi dengan lama hari rawat, daya terima oral dan penyakit yang mendasari. Metode Rancang bangun penelitian adalah kohort prospektif, dengan jumlah subyek 105 pasien anak usia 1 bulan – 18 tahun yang baru pertama kali dirawat di bangsal anak RS.DR.Sardjito. Analisis dengan uji kai-kuadrat, uji t berpasangan dan analisis mulitvariant uji regresi logistik. Hasil Rerata perubahan berat badan sebesar 139 gram ( 0.67%) dengan rerata lama rawat inap 5,8 hari memberikan hasil yang bermakna terhadap penurunan status gizi pasien (p = 0.017). Insiden malnutrisi rumah sakit sebesar 8.57% dan didapatkan dari perawakan pendek 33.3% dan perawakan normal 66.7%. Tidak didapatkan hubungan bermakna antara penurunan status gizi dengan usia, jenis kelamin, panjang/tinggi badan menurut usia, dan penyakit yang mendasari. Dengan analisis multivariat didapatkan hubungan bermakna pada penurunan status gizi dengan lama rawat inap lebih sama dengan 6 hari [OR adjusted 24.4 (IK 95%; 9.8 – 60.6), p = 0.005] dan penurunan status gizi dengan daya terima oral/enteral kurang dari 80% hari [OR adjusted 20.1 (IK 95%; 8.0 – 50.2), p = 0.009]. Simpulan Kejadian malnutrisi rumah sakit di RSUP. Dr. Sardjito sebesar 8.57% dan memerlukan intervensi dan penanganan sedini mungkin. Lama rawat inap lebih sama dengan 6 hari dan daya terima oral/enteral kurang dari 80% merupakan faktor risiko terjadinya penurunan status gizi pasien.

Background Nutritional status of children often experience changes during hospitalization, children with illnesses will decrease appetite, limitations in consuming food and decreased intake of calories and protein. Incidence of hospital malnutrition impact on growth, disease complications, duration of healing, increased length of stay, cost of hospitalization, morbidity and mortality. Objective The aim of the study are to evaluate the body weight changes during treatment resulting in changes in nutritional status of patients and the correlation between hospital malnutrition with length of stay, the acceptance of oral or enteral feeding and underlying disease. Method The study design is a prospective cohort study, 105 subjects with a number of pediatric patients aged 1 month - 18 years old in the first admission at Sardjito general hospital. Analysis by chi-square, paired t test and logistic regression. Results The mean body weight change of 139 grams ( 0.67%) with a mean length of stay 5.8 days is significant to the decreasing of the nutritional status (p = 0017). Incidence of hospital malnutrition is 8.57% and obtained from the short stature 33.3% and 66.7% of normal stature. There were no significant correlation between the decline in nutritional status by age, sex, length / height according to age and underlying disease. Multivariate analysis showed significant correlation with the decline in nutritional status over the same length of stay by 6 days [OR adjusted 24.4 (CI 95%; 9.8 – 60.6), p = 0.005] and a decline in nutritional status with the acceptance of oral / enteral feeding less than 80 % days [OR adjusted 20.1 (CI 95%; 8.0 – 50.2), p = 0.009]. Conclussion incidence of hospital malnutrition in the pediatric ward of the Sardjito hospital is 8.57% and requires intervention and treatment as early as possible. Length of hospitalization is more equal to six days and acceptance of oral / enteral feeding less than 80% is a risk factor for decline in nutritional status of patients.

Kata Kunci : Malnutrisi,Lama hari rawat,Day terima oral/enternal