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Pramadhani, Almira (2019) Hubungan Kadar Asam Laktat dengan Lama Rawat, Keparahan, dan Mortalitas Pasien Sepsis di RSU Dr. Saiful Anwar Malang. Sarjana thesis, Universitas Brawijaya.

Indonesian Abstract

LATAR BELAKANG : Sepsis merupakan penyebab kematian terbanyak ke-11 di seluruh dunia. Kejadian sepsis di seluruh dunia mencapai 27.000.000 orang dalam satu tahun, dan terus meningkat setiap tahunnya. Dari angka tersebut, 800.000 meninggal, sedangkan sisanya mengalami komplikasi jangka panjang. Pada sepsis terjadi rangkaian respons inflamasi sistemik yang tidak teratur. Pada syok septik, terjadi gangguan hemodinamik yang menyebabkan peningkatan kadar asam laktat. TUJUAN : Penelitian ini bertujuan untuk mengetahui hubungan kadar asam laktat dengan lama rawat, keparahan, dan mortalitas pasien sepsis. METODE : Observasional analitik dengan pendekatan kohort. Metode sampling yang digunakan adalah consecutive sampling. Analisis data yang dilakukan adalah uji beda dengan Mann Whitney, uji korelasi Spearman untuk parameter keparahan dan mortalitas terhadap asam laktat dan uji korelasi Pearson untuk parameter lama rawat terhadap asam laktat. Selanjutnya dilakukan uji prognosis dengan tabel 2x2. HASIL : Didapatkan 35 pasien sepsis. Hasil uji beda ditemukan terdapat perbedaan kadar asam laktat berdasarkan keparahan pasien sepsis (p = 0,021), dengan pasien syok sepsis memiliki kadar asam laktat yang lebih tinggi, akan tetapi tidak terdapat perbedaan kadar asam laktat berdasarkan mortalitas pasien sepsis (p = 0,915). Hasil uji korelasi menunjukkan terdapat hubungan yang lemah antara kadar asam laktat dengan keparahan pasien sepsis (r = 0,395, p = 0,019), dan tidak terdapat hubungan antara kadar asam laktat dengan mortalitas pasien sepsis (r = 0,018, p = 0,917) dan lama rawat pasien sepsis (r = -0,346, p = 0,298). Berdasarkan analisis relative risk, kadar asam laktat cut-off 3,4 mmol/L dapat menjadi prediktor terjadinya syok septik (RR 4,235, IK 95%, 1,044 – 17,184; p = 0,027). KESIMPULAN : Kadar asam laktat memiliki hubungan lemah dengan keparahan pasien sepsis, akan tetapi tidak memiliki hubungan dengan mortalitas dan lama rawat pasien sepsis.

English Abstract

BACKGROUND : Sepsis is the 11th most common cause of death worldwide. Sepsis incidence worldwide reaches 27.000,000 people in a year, and continues to increase every year. From these number, 800.000 death, while the rest had a long term complications. In sepsis there is a series of irregular systemic inflammatory responsses. In septic shock, there is a hemodynamic disturbances which causes an increase in lactic acid levels. OBJECTIVES : This study aims to determine the correlations of lactic acid levels with length of stay, severity, and mortality of sepsis patients. METHODS : The sampling method used was consecutive sampling. Data analysis was performed using a comparative test Mann Whitney, the Spearman correlation test for the severity and mortality parameters to lactic acid levels and the Pearson correlation test for the length of stay parameters to lactic acid levels. Then the prognostic test is performed with a 2x2 table. RESULTS : Thirty five sepsis patients were obtained. Comparative test results showed that there were differences in levels of lactic acid based on the severity of sepsis patients (p = 0.021), with septic shock patients have a higher lactic acid level, but there was no difference in lactic acid levels based on the mortality of sepsis patients (p = 0.915). Correlation test results showed that there was a correlation between lactic acid levels with the severity of sepsis patients (r = 0.395, p = 0,019), and there were no correlations between lactic acid levels with the mortality of sepsis patients (r = 0.018, p = 0,917) and length of stay in sepsis patients (r = -0,346, p = 0,298). Based on a relative risk analysis, cut-off levels of lactic acid 3.4 mmol/L could be a predictor of septic shock (RR 4.235, 95% CI, 1.044-17.184; p = 0.027). CONCLUSIONS : Lactic acid level have a weak correlation with the severity of sepsis patients, but does not have correlations with mortality and length of stay of sepsis patients.

Other Language Abstract

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Item Type: Thesis (Sarjana)
Identification Number: SKR/FK/2019/447/052001271
Uncontrolled Keywords: Sepsis, Lama Rawat, Keparahan, Mortalitas, Asam Laktat, Sepsis, Length of Stay, Severity, Mortality, Lactic Acid
Subjects: 600 Technology (Applied sciences) > 616 Diseases > 616.9 Other disease > 616.94 Bacterial blood diseases > 616.944 Septicemia
Divisions: Fakultas Kedokteran > Pendidikan Dokter
Depositing User: Budi Wahyono
URI: http://repository.ub.ac.id/id/eprint/180119
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