Tesis

Stres Psikologis Sebagai Faktor Risiko Tukak Peptikum Perforasi di Masa Pandemi Covid-19 = Psychological Stress as a Risk Factor for Perforated Peptic Ulcers during the Covid-19 Pandemic.

Latar Belakang: Peningkatan insiden tukak peptikum perforasi (TPP) Divisi Bedah digestif RSUPN Dr. Cipto Mangunkusumo Jakarta. Selama enam bulan awal pandemi Covid-19, naik empat kali lipat, dibandingkan enam bulan sebelum pandemi Covid-19. Penelitian ini bertujuan untuk menilai peran stres psikologis sebagai faktor risiko tukak peptikum perforasi. Metodologi: Merupakan studi retrospektif potong lintang, membandingkan 2 kelompok subjek penelitian, TPP pandemi Covid-19 Maret 2020 hingga Maret 2021 dan non-pandemi Covid-19 Juli 2017 hingga Februari 2020. Data demografi, klinis, dan tingkat stres psikologis yang diukur dengan Perceived Stress Scale (PSS10) merupakan variabel yang diperiksa. Hasil: Tercatat 53 TPP, 28 subjek pada pandemi, pria 11, wanita 17, rerata usia 63 tahun, pemakaian obat antiinflamasi nonsteroid atau jamu 80%, komorbid 92,8%, lama rawat 23,6 hari, morbiditas 78,5%, infeksi daerah operasi 17%, pneumonia 38,9%, dan mortalitas 46,4%. 25 subjek pada non-pandemi, pria 21, wanita 4, rerata usia 53 tahun, penggunaan obat antiinflamasi nonsteroid atau jamu 85%, komorbid 48%, rerata skor boey 1,3, PULP 6,8, ASA 3, lama rawat 16,2 hari, morbiditas 52%, infeksi daerah operasi 12%, pneumonia 36%, dan mortalitas 28%. Penilaian PSS10 pada 37 subjek, pada pandemi, stres berat delapan, stres sedang tujuh, stres ringan empat. Pada non-pandemi stres berat satu, stres sedang delapan, stres ringan sembilan. Uji Fischer exact didapatkan perbedaan antara stres ringan-sedang dengan stres berat pada kedua kelompok, p = 0,019. Uji Spearman didapatkan korelasi moderat (rs = 0,422) antara stres psikologis dengan pandemi, p = 0,009. Simpulan: Pandemi Covid-19 memperberat stres psikologis, meningkatkan morbiditas dan mortalitas tukak peptikum perforasi.
Kata kunci: pandemi Covid-19, Perceived Stress Scale, stres psikologis, tukak peptikum perforasi


Background: Increased incidence of perforated peptic ulcer (PPU) Digestive Surgery Division, Dr. Cipto Mangunkusumo Hospital, Jakarta. During early of six months Covid-19 pandemic, increased four times, compared to six months before Covid-19 pandemic. This study aims to evaluate the role of psychological stress as a risk factor for perforated peptic ulcer. Methodology: a cross-sectional retrospective study, compare 2 groups on the PPU subjects of COVID-19 pandemic March 2020 to March 2021 and non-pandemic Covid-19 July 2017 to February 2020. Demographic, clinical, and psychological stress data as measured by Perceived Stress Scale (PSS-10) were variables to be evaluated. Results: Registered 53 PPU, 28 subjects in Covid-19 pandemic, 11 males, 17 females, 63 years mean age, 80% used of nonsteroidal anti-inflammatory drugs or Indonesian herbs, 92.8% comorbidities, 23.6 days length of stay, 78,5% morbidity, 17% surgical site infection, 38.9% pneumonia, and 46,4% mortality. 25 subjects in non-pandemic, 21 males, 4 females, 53 years mean age, 85% non-steroidal antiinflammatory drugs or Indonesian herbs, 48% comorbidity, 1.3 mean boey score, 6.8 PULP, 3 ASA, 16.2 days length of stay, 52% morbidity, 12% surgical site infection, 36% pneumonia, and 28% mortality. PSS-10 evaluated on 37 subjects, in pandemic, eight severe stress, seven moderate stress, four mild stress. In nonpandemic, one severe stress, eight moderate stress, and nine mild stress. Fischer's exact test found a difference between mild-moderate stress and severe stress in both groups, p = 0.019. Spearman's test found a moderate correlation (rs=0.422) between psychological stress and the pandemic, p = 0.009. Conclusion: Covid-19 pandemic exacerbates psychological stress, increasing morbidity and mortality of perforated peptic ulcer.
Keywords: Covid-19 pandemic, perceived stress scale, psychological stress, perforated peptic ulcer