Validitas Skor Apache II, MSofa, dan SAPS 3 Terhadap Mortalitas Pasien Non Bedah di Perawatan Intensif Dewasa RSUP dr Kariadi Semarang
Latar Belakang : Terdapat berbagai model sistem severity of illness, digunakan untuk memprediksi mortalitas, keefektifitasan dan lama rawat di perawatan intensif, memprediksi jumlah perawat yang secara efektif dapat menangani pasien, banyaknya pasien yang dirawat dirumah sakit, penghitungan beban biaya kesehatan, dan salah satu komponen evaluasi performance ICU. Diperlukan penilaian validitas antara sistem severity of illness sehingga dapat diterapkan secara maksimal di perawatan intensif.
Tujuan : Membandingkan validitas sistem skoring APACHE II, MSOFA, dan SAPS3 terhadap mortalitas pasien ICU non bedah di RSUP dr. Kariadi Semarang.
Metode : Penelitian ini adalah uji diagnostik dengan desain kohort retrospektif. Sampel sebanyak 135 sampel dipilih berdasarkan simple random sampling, yang memenuhi kriteria inklusi dan ekslusi. Missing value yakni bilirubin dinilai dan dipertimbangkan dalam interpretasi data. Validitas diperoleh dengan melakukan kalibrasi dan diskriminasi dari hasil penelitian kemudian dibandingkan antara hasil yang didapat.Normalitas data menggunakan uji kolmogorov smirnoff, sementara homogenitas menggunakan uji Levenne. Sampel dikalibrasi denganuji Hosmer Lameshow goodness of fit C, dan area under the receiver operating curve. Penilaian diskriminasi dilakukan dengan uji diagnostik dengan membuat tabel 2x2 dengan komponen pasien outcome, dengan model parsimoni dari tiap-tiap model skoring.
Hasil : Kurva ROC memberikan nilai auROC untuk skoring APACHE II, MSOFA, dan SAPS 3 dengan hasil 0,7981, 0,7620, 0,785. Dari hasil tersebut, ketiga penilaian.
Kesimpulan : Sistem skoring APACHE II, MSOFA dan SAPS 3 cukup baik untuk digunakan sebagai prediktor mortalitas, dengan APACHE II lebih valid dibandingkan MSOFA dan SAPS 3.
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