Analisis Faktor Prediktor Mortalitas Pada Pasien Stroke Hemoragik Di Rumah Sakit Daerah Dr. Soebandi Jember

Darotin, Rida (2017) Analisis Faktor Prediktor Mortalitas Pada Pasien Stroke Hemoragik Di Rumah Sakit Daerah Dr. Soebandi Jember. Magister thesis, Universitas Brawijaya.

Abstract

Stroke adalah penyakit serebrovaskular yang sering ditemukan di negara maju, saat ini juga banyak terdapat di negara berkembang salah satunya di negara Indonesia. Seiring dengan semakin meningkatnya morbiditas dan mortalitas dalam waktu yang bersamaan, dimana di Indonesia peningkatan kasus dapat berdampak negatif terhadap ekonomi dan produktivitas bangsa, karena pengobatan stroke membutuhkan waktu lama dan memerlukan biaya yang besar Prevalensi stroke yang tinggi di Indonesia dipengaruhi oleh beberapa faktor resiko antara lain obesitas, kurang aktifitas fisik, diet tidak sehat, merokok, tekanan darah tinggi, peningkatan gula darah, dan peningkatan lipid darah. Penelitianini adalah penelitian kuantitatif dengan pendekatan retrospektif. Jumlah sampel sebanyak 101 data rekam medis. Untuk mengetahui gambaran masing-masing variabel digunakan analisis univariat, untuk mengetahui hubungan antar variabel digunakan uji chi square dan untuk mengetahui faktor yang paling dominan dalam mempengaruhi mortalitas stroke hemoragik digunakan analisis regresi logistik. Hasil analisis univariat didapatkan bahwa pasien stroke hemoragik yang terbanyak adalah perempuan (59,4%), usia rata-rata 57 tahun, kesadaran buruk 62,4%, Alasan keluar rumah sakit karena mortalitas 72,3%, sebanyak 67,3% mengalami obesitas, 91,1% memiliki tekanan darah tidak normal,57,4% memiliki gula darah tidak normal, 90,1% memiliki profil lipid darah tidak normal. Hasil uji bivariat mengeidentifikasi hubungan antara variabel independen dengan mortalitas stroke hemoragik menunjukkan p value sebagai berikut: obesitas uji chi square p=0,039, tekanan darah uji fisher p=0,478, gula darah uji chi square p=0,04, profil lipid darah uji fisher p=0,026, dimana hubungan dikatakan bermakna apabila p<0,05. Selanjutnya dari analisis multivariat dengan regresi logistik diperoleh hasil sebagai berikut: obesitas p=0,043, OR=2,689,CI 95%=1,034-6,996, gula darah p=0,042, OR=2,656 CI 95%= 1,035-6,813, profil lipid darah P=0,069, OR=3,749, CI95%=0,901-15,602. Terdapat hubungan yang bermakna antara obesitas, gula darah dan profil lipid darah dengan mortalitas pada pasien stroke hemoragik. Obesitas dan gula darah merupakan faktor prediktor yang dapat digunakan untuk memprediksi mortalitas stroke hemoragik, dimana obesitas merupakan faktor yang paling dominan mempengaruhi mortalitas stroke hemoragik. Penelitian ini memiliki keterbatasan yaitu hasil pemeriksaan laboratorium profil lipid darah yang tidak diperiksa secara keseluruhan sehingga peneliti mengambil data profil lipid darah berupa kolesterol total / trigliserid / HDL/ LDL jadi tidak mengambil keempat data. Pemeriksaan tanda-tanda vital (tekanan darah) tidak terpantau sesaat setelah pasien terserang stroke hemoragik sehingga kurang mengetahui hubungan yang kuat antara tekanan darah dengan mortalitas pasien stroke hemoragik.

English Abstract

Stroke is a cerebrovascular disease that is often found in developed countries, currently also there are many in developing countries one of them in the country of Indonesia. Along with the increasing of morbidity and mortality in the same time, where in Indonesia case increase can negatively impact to economy and productivity of nation, because stroke treatment takes a long time and require big cost. High prevalence of stroke in Indonesia influenced by several risk factors, among others Obesity, lack of physical activity, unhealthy diet, smoking, high blood pressure, increased blood sugar, and increased blood lipids. This research is a quantitative research with retrospective approach. The number of samples is 101 medical record data. To know the description of each variable used univariate analysis, to know the relation between variables used chi square test and to know the most dominant factor in influencing mortality of hemorrhagic stroke used logistic regression analysis. The result of univariate analysis showed that most hemorrhagic stroke patients were female (59,4%), mean age 57 years, awareness 62,4%, hospital outcome because 72,3% mortality, 67,3% Obese, 91.1% had abnormal blood pressure, 57,4% had abnormal blood sugar, 90,1% had abnormal blood lipid profiles. The result of bivariate test identified the relationship between independent variable and hemorrhagic stroke mortality showed p value as follows: obesity of chi square test p = 0,039, blood test of fisher test p = 0,478, blood sugar chi square test p = 0,04, blood lipid profile of fisher test p = 0,026 , Where the relation is said to be significant if p <0,05. Furthermore, multivariate analysis with logistic regression obtained the following results: obesity p = 0,043, OR = 2,689, 95% CI = 1,034-6,996, blood sugar p = 0,042, OR = 2,656 CI 95% = 1,035-6,813, blood lipid profile P = 0.069, OR = 3.749, CI95% = 0.901-15.602. There is a significant relationship between obesity, blood sugar and blood lipid profile with mortality of hemorrhagic stroke. Obesity and blood sugar are predictors that can be used to predict the mortality of hemorrhagic stroke, where obesity is the most dominant factor affecting the mortality of hemorrhagic stroke. This study has limitations of laboratory examination blood lipid profile that is not examined as a whole so that researchers take blood lipid profile data in the form of total cholesterol / trigliserid / HDL / LDL so do not take all four data. Examination of vital signs (blood pressure) was not observed shortly after the patient had a hemorrhagic stroke so less knowing the strong relationship between blood pressure and hemorrhagic stroke patient mortality.

Item Type: Thesis (Magister)
Identification Number: TES/616.81/DAR/a/2017/041707333
Uncontrolled Keywords: CEREBROVASCULAR DISEASE, CEREBROVASCULAR DISEASE - MORTALITY, HEART DISEASE - MORTALITY, INDONESIA - JEMBER
Subjects: 600 Technology (Applied sciences) > 616 Diseases > 616.8 Diseases of nervous system and mental disorders > 616.81 Cerebrovascular diseases
Divisions: S2/S3 > Magister Keperawatan, Fakultas Kedokteran
Depositing User: Nur Cholis
Date Deposited: 06 Sep 2017 06:43
Last Modified: 23 Oct 2020 02:23
URI: http://repository.ub.ac.id/id/eprint/2144
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