Skripsi

Hubungan Derajat Cedera Gastrointestinal Akut dengan Skor PELOD 2 di Pediatric Intensive Care Unit Rumah Sakit Cipto Mangunkusumo = Association between Acute Gastrointestinal Injury (AGI) Grade and PELOD-2 Score in Pediatric Intensive Care Unit of Rumah Sakit Cipto Mangunkusumo.

Latar belakang: Cedera gastrointestinal akut seringkali terjadi secara sekunder terhadap penyakit kritis, namun penilaiannya tidak rutin dilaksanakan. Penilaian gagal organ pada pasien anak yang banyak digunakan di Indonesia adalah skor PELOD-2. Penelitian ini bertujuan untuk mengetahui hubungan antara derajat cedera gastrointestinal akut dengan gagal organ yang dinilai berdasarkan skor PELOD-2 pada pasien anak sakit kritis. Metode: Studi potong lintang dengan data sekunder dari rekam medik pasien anak dengan cedera gastrointestinal akut di PICU RSCM dari bulan September 2019September 2020. Derajat cedera gastrointestinal akut dinilai menggunakan kriteria AGI grading system, sedangkan gagal organ dinilai menggunakan skor PELOD-2. Uji statistic Chi Square, Kruskal Wallis dan Mann-Whitney dilakukan menggunakan aplikasi SPSS IBM versi 20. Hasil: Didapatkan 25 sampel dengan median skor PELOD-2 pada derajat satu sebesar 1 (0-5), dua sebesar 1 (0-9), tiga sebesar 9 (n=1), dan empat sebesar 9 (7-11). Hasil Uji Kruskal-Wallis menunjukkan adanya hubungan yang signifikan secara statistik (P= 0,004) dan terdapat peningkatan skor PELOD-2 pada derajat yang lebih tinggi. Selain itu hasil uji Chi Square menunjukkan terdapat hubungan antara derajat cedera gastrointestinal akut dengan mortalitas pasien (P= 0,014). Kesimpulan: Terdapat hubungan yang signifikan secara statistik antara derajat cedera gastrointestinal akut dengan skor PELOD-2 dan luaran mortalitas pada pasien anak sakit kritis.
Kata Kunci: Pediatric Intensive Care Unit, anak sakit kritis, cedera gastrointestinal akut, Pediatric Logistic Organ Dysfunction Score.


Background: Acute gastrointestinal injury can be secondary to critical illness, however it is not often assessed. The instrument used to assess organ dysfunction in children is Pediatric Logistic Organ Dysfunction-2 (PELOD-2) Score. This study aims to explain association between AGI grade and organ dysfunction using PELOD-2 in critically ill pediatric patients. Methods: This is a cross-sectional study with data collected from medical records of pediatric patients with AGI in PICU of Rumah Sakit Cipto Mangunkusumo, starting from September 2019 to 2020. Patients were classified based on AGI grade. The severity of organ dysfunction was measured using PELOD-2. Data were analysed with Chi Square, Kruskal-Wallis and Mann-Whitney test using SPSS IBM version 20. Results: From 25 included pediatric patients, median of PELOD-2 score in AGI grade 1, 2, 3 were 1, 1, 9 respectively. There is only one sample of AGI grade 3, therefore the median of PELOD-2 score cannot be calculated.. Kurskal-Wallis test showed significant association (P: 0.004) with higher PELOD-2 score in more severe AGI grade. Chi Square test also showed significant association (P= 0,014) with higher mortality rate in more sever AGI grade. Conclusion: There is significant association between AGI grade with PELOD-2 score and mortality rate in critically ill pediatric patients.
Keywords: Pediatric Intensive Care Unit, critically ill patients, acute gastrointestinal injury, Pediatric Logistic Organ Dysfunction Score.