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Hubungan Penanda Infeksi, Penanda Oksigenasi, dan Faktor Risiko Lainnya terhadap Mortalitas Pasien COVID-19 dengan Pneumonia Saat Admisi di Unit Perawatan Intensif RSUP Dr. Wahidin Sudirohusodo

Andi Taufik Amiruddin  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia
Haizah Nurdin orcid  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia
Syafri Kamsul Arif  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia
Andi Muhammad Takdir Musba  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia
Andi Salahuddin  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia
*Ari Santri Palinrungi  -  Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin, Makassar, Indonesia

Citation Format:
Abstract

Latar Belakang: Organisasi Kesehatan Dunia (WHO) mendeklarasikan penyebaran dari coronavirus disease 2019 (COVID-19). Faktor risiko terhadap mortalitas pasien COVID-19 rawat intensive care unit (ICU) belum banyak diteliti.

Tujuan: Mengetahui hubungan penanda infeksi, penanda oksigenasi dan faktor risiko lainnya terhadap mortalitas pasien COVID-19 dengan pneumonia.

Metode: Penelitian retrospektif dilakukan di ICU Infection Centre RSUP Dr. Wahidin Sudirohusodo, Makassar pada April – Agustus 2020. Sampel penelitian adalah data pasien COVID-19 dengan pneumonia yang dirawat di ICU. Pasien dibagi ke dalam dua kelompok survivor grup (SG) dan non-survivor (NSG). Variabel penelitian berupa penanda infeksi, penanda oksigenasi dan faktor risiko yang didapatkan dari rekam medis pasien. Analisis bivariat dan multivariat dilakukan terhadap semua variabel penelitian.

Hasil: Dari 92 pasien didapatkan 46 NSG dan 46 SG. Perbandingan jenis kelamin dan indeks massa tubuh antara kedua kelompok tidak signifikan bermakna secara statistik. Tidak didapatkan perbedaan signifikan secara statistik pada level c-reactive protein (CRP) antara kelompok NSG dengan median 91,1 (IQR 32,3-200,45) dan SG 88,95 (IQR 33,50-177,80), p= 0,899. Faktor risiko usia tua, diabetes mellitus (DM), dan peningkatan rasio neutrofil-limfosit (RNL) berdasarkan klasifikasi cut-off signifikan secara statistik pada mortalitas antar kedua kelompok.  Pada NSG didapatkan median usia 60,5 (IQR 53-67,25) vs SG 56 (IQR 35-61,25), p= 0.02. Komorbid DM SG 8 dari 46 pasien (17,4%) dan NSG 17 dari 46 pasien (37%), p = 0,035. Pemeriksaan kadar RNL berdasarkan klasifikasi cut-off > 3,4 NSG 42 dari 46 pasien (91,3%) dan NS 11 dari 46 (23,9%), p= 0,048.  Analisis multivariat regresi logistik didapatkan rasio P/F merupakan faktor risiko independen. Mortalitas pasien COVID-19 dengan pneumonia (OR 0,99 95% CI 0,988-1,00, p = 0,043).  

Kesimpulan: Umur di atas 60 tahun, DM, RNL, dan indeks oksigenasi bermakna secara signifikan terhadap kejadian mortalitas pasien COVID-19 dengan pneumonia, dimana pada indeks oksigenasi yang rendah didapatkan kejadian mortalitas yang tinggi.

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Keywords: COVID-19; faktor risiko; mortalitas; parameter oksigenasi; penanda inflamasi; pneumonia

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