Perbandingan nilai red cell distribution width terhadap mortalitas pada pasien hospital-acquired pneumonia lansia dan dewasa

DESTY GUSTI SARI, dr. Rizka Humardewayanti Asdie, Sp.PD-KPTI; dr.Heni Retnowulan, M.Kes., Sp.PD-KP

2016 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang: Populasi lansia akan mencapai 2 juta jiwa pada tahun 2050. Lansia rentan menderita berbagai penyakit sehingga semakin banyak yang akan berkunjung ke rumah sakit. Hospital-acquired pneumonia (HAP) adalah salah satu infeksi nosokomial tersering dan berhubungan dengan hospitalisasi yang lebih lama serta mortalitas yang tinggi. RDW adalah parameter laboratorium yang berhubungan dengan prognosis beberapa penyakit seperti syok septik, penyakit jantung kongestif, stroke dan community-acquired pneumonia (CAP). Tujuan Penelitian: Peneltian bertujuan untuk mengetahui perbandingan proporsi pasien HAP lansia dan dewasa yang memiliki peningkatan nilai RDW serta hubungan peningkatan nilai RDW dengan peningkatan risiko mortalitas. Metode Penelitian: Penelitian menggunakan metode cross sectional study dan retrospektif cohort study. Subjek penelitian adalah pasien rawat inap terdiagnosis HAP di RSUP Dr. Sardjito periode Maret 2014 hingga Maret 2015. Sebanyak 106 sampel memenuhi kriteria inklusi. Kemudian data dianalisis dengan metode chi-square dan regresi logistik. Hasil Penelitian: Tidak terdapat perbedaan proporsi pasien HAP dengan peningkatan nilai RDW antara pasien lansia dan dewasa(p=0,437). Namun, terdapat beda proporsi pasien HAP dengan nilai Hb �10,7g/dL dan trombosit �275,4x103/uL antara pasien dewasa dan lansia. Terdapat hubungan antara peningkatan nilai RDW dengan risiko mortalitas (p=0,043). Peningkatan nilai RDW dan komorbid sepsis bermakna meningkatkan risiko mortalitas pasien HAP. Kesimpulan: Tidak terdapat perbedaan proporsi pasien HAP dewasa dan lansia terhadap peningkatan nilai RDW. Namun terdapat hubungan antara peningkatan nilai RDW dengan peningkatan risiko mortalitas pasien HAP. Kata Kunci: Hospital-acquired pneumonia (HAP), red cell distribution width (RDW), lansia, dewasa, mortalitas.

Background: The elder population will reach 2 million people in 2050. The elder are vulnerable to suffer from many kinds of diseases, so there will be many people who come to the hospital. Hospital-acquired pneumonia (HAP) is the second-most nosocomial infections which lead to long hospitalization and high risk of mortality of patients. RDW is one of the laboratory parameter that related with some diseases's prognosis such as septic shock, congestive heart failure, stroke and community-acquired pneumonia (CAP). Objective: This study aimed to determine the proportion of adult and elder HAP patients who have increase in RDW level and the relation between the increase in RDW level and the risk of mortality. Method: This study was using cross sectional study and retrospective cohort study methodology. The research subjects were inpatients diagnosed with HAP in RSUP Dr. Sardjito March 2014 until March 2015. A hundred and six patients were eligible in this study. The data were analysed with chi-square and logistic regression. Result: There is no proportion difference in increasing RDW level between adult and elder HAP patients. (p=0,437). But there are proportion difference in Hb �10,7g/dL and thrombocyte �275,4x103/uL between adult and elder HAP patients. There is relation between the increase in RDW level andthe risk of mortality (p=0,043). The increase in RDW level and comorbid sepsis increase the risk of mortality HAP patients significantly. Conclusion: There is no proportion difference in increasing RDW level between adult and elder HAP patients. But there is relation between the increase in RDW level and the risk of mortality HAP patients. Keywords: Hospital-acquired pneumonia (HAP), red cell distribution width (RDW), elder, adult, mortality.

Kata Kunci : Hospital-acquired pneumonia (HAP), red cell distribution width (RDW), lansia, dewasa, mortalitas