Tesis

Ketepatan APACHE-II Memprediksi Mortalitas 30 Hari Pasien Tersangka COVID-19 di ICU = APACHE-II Accuracy Predicting 30-days Mortality of Suspceted COVID-19 Patients in ICU.

Latar Belakang: COVID-19 telah ditetapkan WHO sebagai Kedaruratan Kesehatan Masyarakat Yang Meresahkan Dunia dengan case fatality rate di Indonesia mencapai 8,7% pada April 2020. Dibutuhkan prediktor mortalitas yang baik sebagai salah satu penunjang strategi tatalaksana pasien terutama dalam alokasi sumber daya institusi kesehatan. Tujuan: Studi ini menganalisis ketepatan skor APACHE-II memprediksi mortalitas 30 hari pasien tersangka COVID-19 yang dirawat di ICU. Metode: Penelitian ini merupakan deskriptif analitik retrospektif di RSUPN Cipto Mangunkusumo dan RSUI selama bulan Maret – Agustus 2020. Sebanyak 208 subyek yang sesuai kriteria inklusi dianalisis dari data rekam medis. Data demografis dan penilaian skor APACHE-II dicatat sesuai data rekam medis. Ketepatan dinilai menggunakan uji Hosmer-Lemeshow goodness of fit. Hasil: Angka mortalitas 30 hari pasien tersangka COVID-19 periode MaretAgustus di ICU sebesar 43,7%. Rerata skor APACHE-II seluruh subyek adalah 13,33 ± 8,7. Angka mortalitas aktual adalah 91 subyek, angka mortalitas prediksi 47,4. Uji Hosmer-Lemeshow menunjukkan hasil yang baik dimana prediktor dan aktual tidak berbeda secara statistik (p=0,96) Kesimpulan: Skor APACHE-II tepat dalam memprediksi mortalitas 30 hari pasien tersangka COVID-19 di ICU.
Kata Kunci: COVID-19, mortalitas, ICU, APACHE-II


Background: COVID-19 has been issued as Public Health Emergency of Internatioinal Concern (PHEIC) with a case fatality rate at Indonesia withihn 8,7% on April 2020. Predictors of mortality is needed for one of additional strategy in patient treatment, especially in managing the healthcare provider resources. Goals: This study analyze the accuracy of APACHE-II in predicting 30 days mortality of suspected COVID-19 patients whom admitted to the ICU. Method: This study is a descriptive analysis retrospective at Cipto Mangunkusumo Hospital and Universitas Indonesia Hospital during March to August 2020. A total of 208 subjects who fit the inclusion criteria were analyzed from medical record data. Demographic data and APACHE-II score were recorded according to medical record data. Accuracy were analyzed using Hosmer-Lemeshow goodness of fit test. Results: 30 days mortality for suspected COVID-19 patients during March to August 2020 whom admitted to the ICU in Cipto Mangunkusumo Hospital and Universitas Indonesia Hospital is 43,7%. Mean APACHE-II score for whole subject is 13,33 ± 8,7. The actual mortality rate is 91 subjects, while the predicted mortality rate is 47,4. Hosmer-Lemeshow goodness-of-fit test showing a good result where the predictor and actual isnt statistically different (p=0,96). Conclusion: APACHE-II score is accurate in predicting 30 days mortality of suspected COVID-19 patients in iCU
Keywords: COVID-19, mortality, ICU, APACHE-II