Skripsi

Perbandingan Lama Rawat, Biaya Rumah Sakit, dan Domisili Pasien Acute Limb Ischemia Sebelum dan Selama Pandemi COVID-19 di RS Cipto Mangunkusumo Jakarta = Comparison in Outcomes of Acute Limb Ischemia Patients Before and During COVID-19 Pandemic at Cipto Mangunkusumo Hospital Jakarta.

Latar Belakang Sejak dideklarasikan sebagai pandemi, COVID-19 telah memberikan dampak nyata terhadap pelayanan kesehatan di seluruh dunia. Pandemi memunculkan berbagai keterbatasan penanganan di rumah sakit terlebih bagi pasien non COVID seperti pasien iskemia tungkai akut. Selain terdampak karena urgensi penanganannya, infeksi SARSCoV-2 memperparah iskemia tungkai akut akibat trombosis oleh kondisi hiperkoagulabilitas dan badai sitokin inflamasi. Oleh karena itu, diperlukan peninjauan lebih lanjut untuk mengidentifikasi perbedaan luaran pasien iskemia tungkai akut sebelum dan selama pandemi COVID-19. Metode Data penelitian merupakan data sekunder rekam medis dari Rumah Sakit Cipto Mangunkusumo pada periode 2018–2022 dengan desain kohort retrospektif. Hasil Sebanyak 100 pasien (42 sebelum pandemi dan 58 selama pandemi) dianalisis dan ditemukan besar biaya rumah sakit selama pandemi adalah Rp80,309,347.00 (Rp48,452,806.00–Rp117,626,411.00; p=0.013), sedangkan lama rawat 13.6 hari (8– 31.3; p=0.737) dan domisili pasien 50% Daerah Khusus Jakarta dan 50% Non DKJ (p=0.346). Karakteristik pasien yang memiliki hubungan signifikan adalah hipertensi dengan lama rawat (p=0.026), trombektomi (p=0.006) dan status pandemi (p=0.019) dengan biaya rumah sakit, serta hipertensi (OR 0.34; p=0.035) dan mortalitas (OR 2.5; p=0.049) dengan domisili pasien. Kesimpulan Keberadaan pandemi memiliki dampak terhadap meningkatnya biaya rumah sakit pasien iskemia tungkai akut, tetapi tidak dengan lama rawat dan persebaran domisili pasien.
Kata Kunci: Coronavirus disease, pandemi, iskemia tungkai akut


Introduction Since declared as a global pandemic, COVID-19 has given an immense impact towards healthcare services worldwide. Pandemic has surged various limitations in healthcare responses, especially for non-COVID cases such as acute limb ischemia patients. Aside from its disturbance on ALI urgent treatment, SARS-CoV-2 infection induced acute limb ischemia thrombosis due to the hypercoagulable state and cytokine storm it caused. Further study is crucial to learn about the differences amongst outcomes in ALI patients before and during COVID. Methods Cipto Mangunkusumo Hospital medical records between 2018–2022 were queried and analysed with a retrospective cohort study design. Results In total, 100 patients with acute limb ischemia were analysed (42 pre-COVID and 58 during COVID). The study found hospital costs of Rp80,309,347.00 (Rp48,452,806.00–Rp117,626,411.00; p=0.013), length of hospital stay of 13.6 days (8–31.3; p=0.737) and patients’ residences consisted of 50% Jakarta and 50% Non Jakarta (p=0.346) during the pandemic. Patients’ characteristics that have a significant correlation are hypertension with length of stay (p=0.026), thrombectomy (p=0.006) and pandemic state (p=0.019) for hospital costs, hypertension (OR 0.34; p=0.035) and mortality rate (OR 2.5; p=0.049) towards patients’ residences. Conclusion Pandemic situation impacted ALI patients’ increased hospital costs. However, their length of stay and residences were not affected by the condition.
Keywords: Coronavirus disease, pandemic, acute limb ischemia