Tesis

Faktor-Faktor Yang Memengaruhi Angka Kematian 7 Hari Pada Pasien Covid-19 di IGD Rumah Sakit Universitas Indonesia = Factors Affecting 7-Day Mortality Rate of COVID-19 Patients in University of Indonesia Hospital Emergency Department.

Latar Belakang: Pandemi COVID-19 berdampak pada penanganan pasien di Rumah Sakit, terutama di Instalasi Gawat Darurat (IGD). Dampak pandemi COVID-19 terhadap mortalitas pasien gawat darurat masih kontroversial. Selama pandemi terjadi peningkatan lama rawat IGD, namun angka kematian sebelum dan saat pandemi tidak berbeda bermakna. Kasus kematian 7 hari ini diterapkan sebagai indikator untuk mengukur kematian dini di IGD, karena keputusan klinis yang paling penting dibuat pada minggu pertama setelah masuk rumah sakit. Saat ini belum ada studi yang meneliti faktor risiko kematian 7 hari pada pasien COVID-19 di Indonesia. Metode: Penelitian ini merupakan penelitian deskriptif analitik retrospekstif dengan pengambilan data sekunder pasien terkonfirmasi COVID-19 yang masuk IGD di Rumah Sakit Universitas Indonesia (RSUI) dari Januari sampai Desember 2021. Luaran yang dinilai adalah angka kematian 7 hari pada pasien COVID-19 dan faktor-faktor yang memengaruhinya (lama waktu tunggu, komorbiditas, kriteria triase, derajat keparahan COVID-19). Hasil: Total pasien yang masuk ke IGD RSUI selama tahun 2021 adalah sebesar 3710 pasien dengan pasien terkonfirmasi COVID-19 sebesar 38,6%. Angka kematian 24 jam pada populasi pasien COVID-19 sebesar 5,4%. Angka kematian 7 hari pasien di IGD RSUI sebesar 12,2% (175 pasien). Faktor-faktor yang memengaruhi angka kematian 7 hari di IGD RSUI antara lain derajat keparahan COVID-19 (RR 7,1;IK 95% [4,055-12,515]), kriteria triase (RR 4,2;IK 95% [2,763-6,452]), dan komorbiditas (RR 4,2;IK 95% [2,679-6,613]). Hasil penelitian ini menunjukkan bahwa lama waktu tunggu tidak meningkatkan risiko kematian 7 hari (RR 1,01; IK 95% [0,975-1,050]; p=0,595). Simpulan: Faktor-faktor yang memengaruhi angka kematian 7 hari di IGD RSUI adalah komorbiditas, kriteria triase, derajat keparahan COVID-19. Lama waktu tunggu pasien di IGD tidak memiliki hubungan yang signifikan terhadap angka kematian 7 hari.
Kata Kunci: COVID-19, delta, angka kematian 7 hari, IGD, faktor risiko


Background: The COVID-19 pandemic has had an impact on the treatment of patients in hospitals, especially in the Emergency Department (ED). The impact of the COVID-19 pandemic on mortality in emergency department patients is still controversial. During the pandemic there was an increase in the length of stay in the emergency room, but the mortality rate before and during the pandemic was not significantly different. 7-day mortality was recently applied as an indicator to measure early death in the ED, because the most important clinical decisions are made in the first week after admission. Currently, there are no studies that examine the risk factors for 7-day death in COVID-19 patients in Indonesia. Methods: This study is a retrospective analytic descriptive study by collecting secondary data from patients with confirmed COVID-19 who entered the emergency room at the University of Indonesia Hospital (RSUI) from January to December 2021. The outcomes assessed were the 7-day mortality rate in COVID- 19 patients and its risk factors (ED waiting time, comorbidity, triage criteria, degree of severity of COVID-19). Results: The total number of patients admitted to the RSUI ED during 2021 was 3710 patients with confirmed COVID-19 patients at 38.6%. The 24-hour mortality rate in the COVID-19 patient population is 5.4%. The 7-day mortality rate of patients in RSUI ED was 12.2% (175 patients). Factors that influence the 7-day mortality rate in the RSUI ED include the degree of severity of COVID-19 (RR 7,1; CI 95% [4,055-12,515]), triage criteria (RR 4,2; CI 95% [2,763-6,452]), and comorbidity (RR 4,2; CI 95% [2,679-6,613]). The results of this study indicated that ED waiting time did not increase the risk of 7-day mortality (RR 1,01 ; CI 95% [0,975-1,050]; p=0,595). Conclusion: The factors that influence the 7-day mortality rate in the RSUI ED are comorbidities, triage criteria, and the degree of severity of COVID-19. The patient's ED waiting time has no significant relationship to the 7-day mortality rate.
Keywords: COVID-19, delta, 7-day mortality, emergency department, risk factors