Tesis

Performa Skor PSI dan CURB 65 dalam Memprediksi 30 Hari Kematian Pasien COVID-19 Geriatri = Performance of Pneumonia Severity Index and CURB 65 in Predicting 30-day Mortality in Geriatric Patients with COVID- 19.

Latar belakang. Virus COVID-19 merupakan salah satu penyebab pneumonia yang dapat juga bersifat berat bahkan kritis. Pada populasi usia tua dengan COVID-19 terjadi risiko tinggi komplikasi, dengan angka kematian yang tertinggi. Skor prediksi klinis PSI dan CURB-65 juga dapat digunakan untuk memprediksi kematian akibat COVID-19, sama efektifnya seperti pada kasus pneumonia non-COVID-19. Tujuan. Mengetahui performa skor PSI dan CURB-65 dalam memprediksi 30 hari kematian pasien geriatri dengan COVID-19. Metode. Kohort retrospektifmenggunakan data rekam medis pasien pneumonia COVID- 19 berusia minimal 60 tahun dari Desember 2020 – Juni 2023 di RSUPN Dr. Cipto Mangunkusumo. AUC kedua skor akan dibandingkan. Hasil. Dari 557 subjek, sebanyak 172 subjek (30,88%) meninggal dalam 30 hari. Skor CURB-65 ≥ 4 memiliki nilai spesifisitas paling baik yakni 96,62%, skor PSI kelas risiko ≥ III, memiliki nilai sensitivitas paling baik yakni 95,51%. AUC skor PSI (AUC: 0,789, 95%IK 0,749 – 0,829) maupun CURB-65 (AUC: 0,758, 95%IK 0,714 – 0,803) tergolong cukup baik, serta tidak terdapat perbedaan dalam memprediksi kematian 30 hari pasien geriatri dengan pneumonia COVID-19 (p=0,11). Kesimpulan. Performa skor PSI maupun CURB-65 sama baiknya dalam memprediksi 30 hari kematian pasien geriatri dengan pneumonia COVID-19
Kata kunci. COVID-19, CURB 65, geriatri, kematian, PSI


Background. The COVID-19 virus is one of the causes of pneumonia which can be severe and even critical. In the elderly population with COVID-19, there is a high risk of complications, with the highest mortality rate. Pneumonia severity index (PSI) and CURB-65 as clinical prediction scores can also be used to predict mortality from COVID- 19, just as effectively as in non-COVID-19 pneumonia cases. Objective. To determine the performance of PSI and CURB-65 scores in predicting 30 days of mortality in geriatric patients with COVID-19. Methods. Retrospective cohort using medical records of COVID-19 pneumonia patients aged at least 60 years, from December 2020 – June 2023, at RSUPN Dr. Cipto Mangunkusumo. The AUC of both scores will be compared. Results. Of the 557 subjects, 172 subjects (30.88%) died within 30 days. The CURB-65 score ≥ 4 has the best specificity value of 96.62%, the risk class PSI score ≥ III has the best sensitivity value of 95.51%. AUC PSI (AUC: 0.789, 95%CI 0.749 – 0.829) and CURB- 65 (AUC: 0.758, 95%CI 0.714 – 0.803) were quite good, and there was no difference in predicting 30-day mortality in geriatric patients with COVID-19 pneumonia (p=0.11). Conclusion. The performance of both PSI and CURB-65 scores is equally good in predicting 30-day mortality in geriatric patients with COVID-19 pneumonia.
Keywords. COVID-19, CURB 65, geriatric, mortality, PSI