Tesis

Faktor-Faktor yang Memengaruhi Perubahan Berat Badan selama Perawatan pada Pasien Dewasa Rawat Inap = Factors Affecting in-Hospital Weight Change among Adult Hospitalized Patients.

Latar Belakang. Malnutrisi rumah sakit masih menjadi masalah global. Menemukenali malnutrisi selama perawatan serta faktor-faktor yang memengaruhi sangat penting untuk mencegah luaran yang buruk. Tujuan. Mengetahui angka kejadian perubahan berat badan selama perawatan dan faktor-faktor yang memengaruhi pada pasien dewasa rawat inap. Metode. Desain kohort prospektif pada pasien usia 18-59 tahun. Pasien yang memenuhi inklusi dan eksklusi dilakukan pencatatan data demografis, Charlson Commorbidity Index (CCI), Rasio Neutrofil-Limfosit (RNL), Beck Depression Inventory-II (BDI-II), imobilitas, polifarmasi, lama rawat, dan asupan energi. Pengukuran antropometri dilakukan pada awal dan akhir perawatan. Asupan energi diukur dengan metode Food Weighing untuk makanan dari rumah sakit dan Food Record untuk makanan dari luar rumah sakit. Analisis bivariat dan multivariat dilakukan pada faktor-faktor tersebut. Hasil. Terdapat 30 pasien yang diamati, dengan rerata usia 40,5 ± 11,6 tahun. Median lama rawat 6 (3 - 14) hari, median CCI 1 (0-7), median BDI 13 (3-35), dan median RNL 5 (1,1 – 19,6). Mayoritas pasien dirawat karena penyakit gastrointestinal akut dengan gejala depresi dan gizi kurang awal rawat didapatkan berturut-turut 33,3% dan 23,3% pasien. Sebanyak 46,7% pasien mengalami polifarmasi, 16,7% pasien mengalami imobilitas, dan 46,7% pasien mengalami penurunan berat badan selama perawatan. Didapatkan penurunan median berat badan 0,15 kg selama perawatan (p = 0,171). Analisis regresi linear berganda memperlihatkan imobilitas dan lama rawat dapat memprediksi 49,9% kejadian perubahan berat badan selama perawatan (Uji F; p ≤ 0,0001). Kesimpulan. Terdapat kecenderungan penurunan berat badan selama perawatan pada pasien dewasa rawat inap. Imobilitas dan lama rawat memengaruhi perubahan berat badan selama perawatan
Kata kunci: Antropometri, Food Weighing, Malnutrisi, Perubahan berat badan


Background. Hospital malnutrition still pose a global problem. Identifying hospital malnutrition and related factors is important in order to prevent poor clinical outcome. Aim. To determine weight change and related factors among adult hospitalized patients. Method. A prospective cohort study recruited adult hospitalized patients aged 18-59 years. Patients who fulfilled the inclusion and exclusion criteria were assessed on demographic data, Charlson Comorbidity Index (CCI), Neutrophil-Lymphocyte Ratio (NLR), Beck Depression Inventory-II (BDI-II), immobility, polypharmacy, length of stay, and energy intake data. Anthropometric measurement was performed upon admission and discharge. Energy intake was collected using Food Weighing method on hospital meal, and Food Record on non-hospital meal. Bivariate and multivariate analysis were carried out on those factors. Result. Among 30 patients observed, mean age was 40.5 ± 11.6 years. Median length of stay was 6 (3 - 14) days, median CCI was 1 (0-7), median BDI was 13 (3-35), and median NLR was 5 (1.1 – 19.6). Majority of patients were hospitalized due to acute gastrointestinal disease. Depression and underweight were found among 33.3% and 23.3% patients, respectively. As much as 46.7% patients had polypharmacy, 16.7% patients had immobility, and 46.7% patients had weight loss during hospitalization. There was 0.15 kg weight loss observed (p = 0.171). Multiple linear regression analysis concluded that immobility and length of stay predict 49.9% in-hospital weight change (F test; p ≤ 0.0001). Conclusion. There is an insignificant weight loss detected among adult hospitalized patients. Immobility and length of stay can affect in-hospital weight change.
Keywords: Malnutrition, Anthropometric, Weight change, Food Weighing