Skripsi

Prediktor Rawat Ulang dan Kematian Pasien Gagal Jantung dengan Fraksi Ejeksi Berkurang (HFrEF) di Rumah Sakit Harapan Kita Tahun 2022 = Predictor of Readmission and Mortality in Heart Failure with Reduced Ejection Fraction (HFrEF) Patients at Harapan Kita Hospital in 2022.

Latar Belakang Gagal jantung merupakan penyebab kematian jantung terbanyak kedua di Indonesia. Berdasarkan data Rumah Sakit Pusat Jantung dan Pembuluh Darah Harapan Kita (RSJPDHK), angka kematian HFrEF meningkat dari tahun 2017-2021. Tujuan Mengetahui prediktor rawat ulang dan kematian pasien HFrEF di RSJPDHK tahun 2022 dalam follow up satu tahun. Metode Penelitian ini bersifat analitik dengan desain fixed cohort untuk melihat kematian dan rawat ulang pasien HFrEF di RSJPDHK. Hasil Total populasi pasien HFrEF 2022 sebanyak 1951 orang, dengan sampel penelitian sebesar 452 orang. Proporsi rawat ulang 47% (n=214), kematian 21% (n=97), lost to follow up 25,8% (n=117). Analisis menunjukkan bahwa faktor yang mempengaruhi rawat ulang adalah usia 61-70 tahun (p 0,027, OR 0,26), pendidikan rendah (p 0,024, OR 0,38), chronic kidney disease (p 0.025, OR 1,56), dan hiponatremia (p 0,017, OR 2,10). Faktor independen terhadap luaran kematian adalah pendidikan rendah (p 0,009, HR 2,33), NTproBNP tinggi (p < 0,001, HR 1,01), dan lama rawat RS ≥ 7 hari (p 0,031, HR 1,61). Kesimpulan Prediktor rawat ulang pasien HFrEF adalah usia 61-70 tahun, pendidikan rendah, chronic kidney disease, dan hiponatremia. Prediktor kematian pasien HFrEF adalah pendidikan rendah, NTproBNP tinggi, dan lama rawat RS ≥ 7 hari.
Kata Kunci: Follow up satu tahun, Gagal Jantung Reduced Ejection Fraction, Kematian, Prediksi, Rawat Ulang


Introduction Heart failure is the second-leading cause of death in Indonesia. Data from Harapan Kita Hospital (RSJPDHK), showed the mortality rate of HFrEF had increased from 2017 to 2021. Aim To determine the predictors of one-year-readmission and one-year-mortality rate of HFrEF patient at RSJPDHK in 2022. Method This analytic study with a fixed cohort design focus on investigating the survival and readmission rate of HFrEF patients at RSJPDHK. Results In 2022, there were 1,951 HFrEF patients, sample were 452 individuals. The readmission rate was 47% (n=214), mortality rate was 21% (n=97), and lost to follow-up rate was 25.8% (n=117). Analysis revealed that factors affecting readmissions are age 61-70 years old (p 0,027, OR 0,26), low education (p 0,024, OR 0,38), chronic kidney disease (p 0,025, OR 1,56), and hyponatremia (p 0,017, OR 2,10). Independent factors affecting mortality rate including low education (p 0,010, HR 2.33), high NTproBNP (p < 0,001, HR 1,01), and hospital stay ≥ 7 days (p 0,031, HR 1.61). Conclusion In HFrEF patients, the predictors for readmission are age 61-70 years old, low education, chronic kidney disease, and hyponatremia, while the predictors for mortality are low education, high NT-proBNP, and hospital stays ≥7 days.
Keywords: Heart Failure with Reduced Ejection Fraction, Readmission, Mortality, one-year-follow-up Predictors