Tesis

Faktor-Faktor yang Berhubungan dengan Mortalitas Pasien Acute Kidney Injury di Unit Perawatan Intensif di RSUPN dr. Cipto Mangunkusumo = Factors Associated with Mortality of Acute Kidney Injury Patients In Intensive Care Unit At dr. Cipto Mangunkusumo National Central General Hospital.

Latar Belakang : Kejadian AKI di unit perawatan intensif berhubungan dengan peningkatan mortalitas, morbiditas pasca AKI dan biaya perawatan tinggi. Penelitian mengenai faktor-faktor yang berhubungan dengan mortalitas pasien AKI di unit perawatan intensif di Indonesia khususnya RSUPN dr. Cipto Mangungkusumo belum pernah dilakukan. Tujuan: Mengetahui prevalensi AKI, angka mortalitas pasien AKI, dan faktor- faktor yang berhubungan dengan peningkatan mortalitas pasien AKI di unit perawatan intensif di ICU RSUPN dr. Cipto Mangunkusumo. Metode : Penelitian kohort retrospektif terhadap seluruh AKI di unit perawatan intensif di RSUPN Cipto Mangunkusumo periode Januari 2015 – Desember 2016. Dilakukan analisis hubungan bivariat saampai dengan multvariat dengan STATA Statistics 15.0 antara faktor usia >60 tahun, sepsis, ventilator, durasi ventilator, dialisis, oligoanuria, dan skor APACHE II saat admisi dengan mortalitas. Hasil : Prevalensi pasien AKI di unit perawatan intensif didapatkan 12,25% (675 dari 5511 subjek) dan sebanyak 220 subjek (32,59%) dari 675 subjek yang dianalisis meninggal di unit perawatan intensif. Faktor-faktor yang berhubungan dengan peningkatan mortalitas pada analisis multivariat adalah sepsis (OR 6,174; IK95% 3,116-12,233), oligoanuria (OR 4,173; IK95% 2,104-8,274), ventilator (OR 3,085; IK95% 1,348-7,057), (skor APACHE II saat admisi) [OR 1,597; IK95% 1,154-2,209], dan durasi ventilator (OR 1,062; IK95% 1,012-1,114). Simpulan : Prevalensi pasien AKI dan angka mortalitasnya di unit perawatan intensif RSUPN dr. Cipto Mangunkusumo didapatkan sebesar 12,25% dan 32,59%. Sepsis, oligoanuria, ventilator, (skor APACHE II saat admisi) , dan durasi ventilator merupakan faktor-faktor yang berhubungan bermakna dengan peningkatan mortalitas pasien AKI di unit perawatan intensif.
Kata Kunci : Acute Kidney Injury, Faktor Risiko, Mortalitas, Unit Perawatan Intensif


Background : Acute kidney Injury (AKI) in ICU associated with increased mortality rate, morbidity post-AKI, and high health care cost. There is no previous study about factors associated with mortality of AKI patients in ICU in Indonesia, especially at dr. Cipto Mangunkusumo National Central General Hospital. Aim : To identify prevalence, mortality rate, and factors associated with mortality of AKI patients in ICU. Method : This is a retrospective cohort study. Data were obtained from all of medical records of AKI patients period January 2015 until December 2016 in ICU at Cipto Mangunkusumo hospital. Association of risk factors (age >60 years old, sepsis, ventilator, duration of ventilator, oligoanuria, and APACHE II score at admission) and mortality will be analyzed using STATA Statistics 15.0. Results : AKI prevalence in ICU was 12,25% (675 subjects from total 5511 subjects). A total of 220 subjects out of 675 subjects AKI died at ICU. Sepsis (OR 6,174; 95%CI 3,116-12,233), oligoanuria (OR 4,173; 95%CI 2,104-8,274), ventilator (OR 3,085; 95%CI 1,348-7,057), (APACHE II score at admission) [OR 1,597; 95%CI 1,154-2,209], and duration of ventilator (OR 1,062; 95%CI 1,012-1,114). were significant factors associated with mortality of AKI patients in ICU. Conclusion : AKI prevalence and mortality rate in ICU at dr. Cipto Mangunkusumo National Central General Hospital were 12,25% and 32,59%. Sepsis, oligoanuria, ventilator, (APACHE II score at admission) 1/2, and duration of ventilator were significant factors associated with mortality of AKI patients in ICU.
Keywords : Acute Kidney Injury, Intensive Care Unit, Mortality, Risk Factor