Skripsi

Capaian Penyelesaian dan Luaran Hour-1 Sepsis Bundle oleh Dokter Umum Instalasi Gawat Darurat Rumah Sakit Universitas Indonesia Bulan Januari-Juni 2024 = Completion and Outcomes of the Hour-1 Sepsis Bundle by General Practitioners at Emergency Department of Universitas Indonesia Hospital January–June 2024.

Latar Belakang: Sepsis merupakan disfungsi organ akibat respons tubuh yang tidak terkontrol terhadap infeksi dan merupakan salah satu penyebab utama kematian di dunia. Pedoman Surviving Sepsis Campaign 2018 memperkenalkan Hour-1 Sepsis Bundle yang menggabungkan tata laksana 3 jam dan 6 jam menjadi satu jam untuk mempercepat intervensi. Namun, data capaian penyelesaian dan luaran penerapannya di Indonesia, khususnya oleh dokter umum di Instalasi Gawat Darurat (IGD), masih terbatas. Metode: Penelitian ini menggunakan desain deskriptif potong-lintang retrospektif dengan total sampling terhadap 157 pasien dewasa dengan diagnosis sepsis yang ditangani dokter umum di IGD Rumah Sakit Universitas Indonesia periode Januari–Juni 2024. Data diambil dari rekam medis dan dianalisis secara deskriptif meliputi karakteristik pasien, capaian penyelesaian Hour-1 Sepsis Bundle, dan luaran pasien. Hasil: Median usia pasien adalah 61 (22–88) tahun, dengan proporsi laki-laki sebesar 52,2%. Komorbiditas tersering berupa penyakit kardiovaskular (49,7%), dengan derajat terbanyak berupa sepsis (61,8%). Sumber infeksi utama berasal dari paru (54,8%), mayoritas pasien tercatat sebagai peserta BPJS (97,5%), dan waktu kedatangan terbanyak terjadi pada periode siang hari (43,3%). Pada pasien sepsis, pengukuran kadar laktat dalam 1 jam pertama dilakukan pada 67,0% pasien, kultur darah 13,4%, dan pemberian antibiotik spektrum luas 30,9%. Pada pasien syok sepsis, pengukuran kadar laktat dilakukan pada 85,0% pasien, kultur darah 11,7%, pemberian antibiotik 33,3%, pemberian cairan kristaloid 0%, dan vasopressor 25,0%. Luaran pasien dari IGD menunjukkan 92,8% pasien sepsis hidup dan 7,2% meninggal, sedangkan pada syok sepsis 86,7% pasien hidup dan 13,3% pasien meninggal. Kesimpulan: Penelitian ini menunjukkan karakteristik pasien, capaian penyelesaian, dan luaran dari Hour-1 Sepsis Bundle oleh dokter umum di IGD Rumah Sakit Universitas Indonesia.
Kata kunci: Sepsis, Hour-1 Sepsis Bundle, capaian penyelesaian, luaran pasien, Instalasi Gawat Darurat


Background: Sepsis is an organ dysfunction caused by a dysregulated host response to infection and remains a major cause of mortality worldwide. The 2018 Surviving Sepsis Campaign introduced the Hour-1 Sepsis Bundle, merging the 3- and 6-hour bundles into one hour to accelerate interventions. However, data on its completion and outcomes in Indonesia, especially by general practitioners in emergency departments, are limited. Methods: This descriptive cross-sectional retrospective study included 157 adult sepsis patients managed by general practitioners at the Emergency Department of Universitas Indonesia Hospital from January to June 2024. Data from medical records were analyzed descriptively, covering patient characteristics, Hour-1 Sepsis Bundle completion, and patient outcomes. Results: The median patient age was 61 (22–88) years, with males comprising 52.2% of cases. The most common comorbidity was cardiovascular disease (49.7%), with sepsis as the predominant clinical category (61.8%). The lungs were the main source of infection (54.8%), most patients were covered by BPJS (97.5%), and the majority arrived during daytime hours (43.3%). In sepsis cases, lactate measurement within the first hour was performed in 67.0% of patients, blood cultures in 13.4%, and broad-spectrum antibiotics were administered in 30.9%. In septic shock, lactate measurement was completed in 85.0% of patients, blood cultures in 11.7%, antibiotic administration in 33.3%, with no patients receiving a 30 mL/kg crystalloid bolus, and vasopressors administered in 25.0%. Emergency department outcomes showed that 92.8% of sepsis patients survived and 7.2% died, while in septic shock, 86.7% survived and 13.3% died. Conclusion: This study describes the patient characteristics, bundle completion performance, and clinical outcomes of the Hour-1 Sepsis Bundle implemented by general practitioners in the Emergency Department of Universitas Indonesia Hospital.
Keywords: Sepsis, Hour-1 Sepsis Bundle, completion rate, patient outcomes, emergency department