Tesis

PROPORSI DAN KARAKTERISTIK KLINIS INFEKSI TUBERKULOSIS EKSTRA-PARU ABDOMINAL DAN NON-ABDOMINAL PADA PASIEN YANG DIRAWAT DI RUMAH SAKIT TERSIER = PROPORTION AND CLINICAL CHARACTERISTICS OF ABDOMINAL AND NON-ABDOMINAL EXTRA-PULMONARY TUBERCULOSIS INFECTION IN PATIENTS ADMITTED TO TERTIARY HOSPITALS.

Latar Belakang : Tuberkulosis (TB) merupakan salah satu dari sepuluh penyebab kematian tertinggi di dunia. Manifestasi infeksi TB yang utama terdapat pada paruparu, namun infeksinya dapat berkembang ke lokasi lain yang disebut juga TB ekstra-paru (TBEP). TBEP abdominal merupakan manifestasi tersering ketiga dari semua TBEP dan terdapat pada satu dari tujuh pasien yang menderita TBEP yang dirawat di rumah sakit. TBEP abdominal melingkupi bagian dari traktus gastrointestinal, peritoneum, nodus limfe dan organ lain dalam abdomen seperti hepar, lien dan pankreas. Tujuan : Mengetahui proporsi TBEP abdominal terhadap TBEP non-abdominal, mendapatkan karakteristik demografis dan klinis TBEP abdominal serta TBEP nonabdominal di ruang perawatan RSCM. Metode : Studi retrospektif ini dilakukan pada semua pasien TBEP yang dirawat di RSCM antara Januari 2016 - Desember 2020. Data karakteristik demografis dan klinis TBEP abdominal dan TBEP non-abdominal didapatkan dari resume medis perawatan pada subjek penelitian sama atau di atas 18 tahun dan minimal informasi dalam resume adalah data demografis, diagnosis beserta tindakan/keterangan saat keluar rumah sakit serta dilakukan periksa silang dengan data TB01/SITT Kemenkes dan data Kunjungan Poli RSCM untuk keberadaan penyakit penyerta. Hasil : Dari 861 pasien TBEP, terdapat 117 (13,59%) pasien TBEP abdominal yang dirawat di RS dalam 5 tahun terakhir, dengan median 34 (19-79) tahun, dan lebih banyak perempuan 65 orang (55,56%), serta median usia perempuan lebih muda dari laki-laki (32 (19-79) tahun vs 37 (20-75) tahun). Pasien lansia ( > 60 tahun) kurang dari 10%. Gambaran klinis tersering TB usus (47,01%) disusul TB peritoneum (41,88%), dengan komorbid terbanyak riwayat TB paru dan penyakit ginjal kronik (16,24%), disertai keluhan terbanyak nyeri abdomen (56,41%) dan berat badan turun (45,30%). Beratnya kondisi awal saat perawatan, malnutrisi (46,15%) dan obstruksi (22,22%), menyebabkan tingkat kematian TBEP abdominal (16,24%) jauh lebih tinggi dari TBEP non-abdominal (2,96%). Simpulan : Proporsi TBEP abdominal 13,59%, lebih banyak perempuan di usia relatif muda dengan gambaran tersering TB usus, dengan manifestasi utama nyeri abdomen, penurunan berat badan, dan malnutrisi.
Kata kunci: Abdominal, Ekstra-paru, Pasien rawat, Tuberkulosis


Background: Tuberculosis (TB) is one of the ten highest causes of death worldwide. The main manifestation of TB infection is present in the lungs, but the infection can progress to another location called extrapulmonary tuberculosis (EPTB). Abdominal EPTB is the third most common manifestation of all EPTB and is present in one in seven hospitalized patients with EPTB. Abdominal EPTB covers parts of the gastrointestinal tract, peritoneum, lymph nodes, and other organs in the abdomen such as the liver, spleen, and pancreas. Objective: Find out the proportion, demographic and clinical characteristics of abdominal and non-abdominal TBEP in the RSCM wardroom. Methods: These retrospective studies were conducted on all EPTB patients admitted to RSCM between January 2016 - December 2020. Demographic and clinical characteristic data of abdominal and non-abdominal EPTB obtained from medical care resumes on study subjects equal to or over 18 years of age. The minimum required information in the resume is demographic data, diagnosis, and actions/information when leaving the hospital and cross-check with data outpatient RSCM and form TB01/SITT data Ministry of Health for comorbidity. Results: Of the 861 EPTB patients, there were 117 (13.59%) abdominal EPTB patients admitted to the hospital in the past five years, with a median of 34 (19-79) years, and most women 65 (55.56%), as well as the median age of women younger than men (32 (19-79) years vs. 37 (20-75). Elderly patients ( > 60 years old) less than 10%. The most common clinical characteristics were intestinal tuberculosis (47.01%) followed by peritonitis TB (41.88%), with comorbid most commonly pulmonary tuberculosis and chronic kidney disease (16.24%), accompanied by the most complaints being abdominal pain (56.41%) and weight loss (45.30%). The severity of the initial conditions during treatment, malnutrition (46.15%) and obstruction (22.22%), led to a much higher mortality rate of abdominal EPTB (16.24%) than non-abdominal EPTB (2.96%). Conclusions: The proportion of abdominal EPTB is 13.59%, most women at a relatively young age with the most common diagnosis is intestinal TB, with the main manifestations of abdominal pain, weight loss, and malnutrition.
Keywords: Abdominal, Extrapulmonary, Hospitalized, Tuberculosis