Tesis

Hubungan Anemia dan Malnutrisi dengan Kejadian Infeksi Saluran Kemih Pada Cedera Medula Spinalis = The Relationship Between Anaemia and Malnutrition with The Incidence of Urinary Tract Infection in Spinal Cord Injury.

Objektif: Untuk mengetahui prevalensi pasien Cedera Medula Spinalis (CMS) yang mengalami Infeksi Saluran Kemih (ISK) dan mengetahui hubungan anemia dan malnutrisi dengan kejadian ISK. Sehingga, dapat membantu mencegah insidensi ISK, meningkatkan efisiensi program rehabilitasi serta meningkatkan kualitas hidup pasien CMS. Metode: Penelitian ini merupakan studi potong lintang menggunakan data rekam medis pasien CMS yang di rawat inap di Rumah Sakit Umum Pusat (RSUP) Fatmawati pada periode Januari 2017 hingga Oktober 2022. Penelitian dilakukan di Instalasi Rekam Medis RSUP Fatmawati mulai bulan Agustus hingga November 2023. Hasil: Jumlah subjek penelitian sebesar 116 subjek. Median usia subjek pada penelitian adalah 36 (18-59) tahun. Kejadian ISK pada pasien CMS adalah sebesar 47,4%. Hasil analisis hubungan anemia dan malnutrisi dengan kejadian ISK menunjukkan hasil yang tidak berbeda bermakna (p>0,05). Hasil analisis multivariat menunjukkan hubungan yang bermakna antara metode eliminasi urin menggunakan kateter dengan kejadian ISK (p = 0.018, OR 2.239, 95% CI 1.152- 4.355). Kesimpulan: Prevalensi ISK pada pasien CMS ditemukan cukup tinggi. Tidak ditemukan hubungan antara anemia dan malnutrisi dengan kejadian ISK. Metode eliminasi urin menggunakan kateter merupakan faktor risiko yang paling berpengaruh terhadap kejadian ISK. Faktor lainnya yang berhubungan dengan ISK yaitu ulkus tekan, etiologi dan tingkat keparahan cedera. Tidak ada perbedaan bermakna antara jenis kelamin, usia, durasi rawat dan komorbid dengan kejadian ISK. Pasien CMS perlu mendapat edukasi memadai mengenai ISK yang rentan terjadi, serta diperlukan juga skrining rutin pemeriksaan urin.
Kata kunci: Cedera medula spinalis, infeksi saluran kemih, anemia, malnutrisi


Objectif: To determine the prevalence of Urinary Tract Infection (UTI) in Spinal Cord Injury (SCI) patients and the relationship between anaemia and malnutrition with the incidence of UTI in SCI. Thus, it can help prevent UTI incidences, increase the efficiency of rehabilitation programs and improve the quality of life of SCI patients. Method: This is a cross-sectional study using medical record data of SCI patients who were hospitalized at the Fatmawati Central General Hospital (RSUP) in the period from January 2017 to October 2022. The research was conducted at the Medical Record Installation of Fatmawati Hospital from August 2023 to November 2023. Results: Total subjects were 116 subjects. The median of subject’s age was 36 (18- 59) years. The incidence of UTI in SCI patients was 47.4%. The relationship between anaemia and malnutrition with the incidence of UTI showed no significant different (p>0.05). Multivariate analysis showed a significant association between urinary elimination method with catheter and the UTI incidence (p = 0.018, OR 2.239, 95% CI 1.152-4.355). Conclusion: The prevalence of UTI in SCI patients was high. There was no association between anaemia and malnutrition with UTI incidence. Urinary elimination method with catheter was the most influential risk factor in UTI. Other factors associated with UTI were pressure ulcers, etiology and severity of injury. There was no significant difference between gender, age, duration of stay and comorbidities with the incidence of UTI. SCI patients need to be adequately educated about the susceptibility of UTI, and routine urine screening is also needed to prevent UTI.
Keywords: Spinal cord injury, urinary tract infection, anaemia, malnutrition