Perbandingan Validitas Sistem Skoring Apache II, SOFA, Dan Customized Sequential Organ Failure Assessment (Csofa) Untuk Memperkirakan Mortalitas Pasien Non-Bedah Yang Dirawat Di Ruang Perawatan Intensif

Latar Belakang : Penerapan Sistem Jaminan Kesehatan Nasional (SJKN) dalam pelayanan ICU mendorong pelayanan ICU untuk lebih efektif dan efisien. Prediksi hasil perawatan penting baik secara administrasi ataupun klinis dalam manajemen ICU. Pasien non-bedah meskipun jumlahnya tidak banyak, namun memiliki angka mortalitas yang tinggi.
Tujuan : Untuk mendapatkan sistem skoring yang baik dan mudah diterapkan dilakukan penilaian missing value, dan diskriminasi dari masing masing sistem skoring.
Metode : Penelitian ini melibatkan 184 pasien non-bedah yang dirawat di ICU RSUP Sanglah Denpasar yang diambil secara retrospektif dari data tanggal 1 Januari 2014 sampai dengan 31 Desember 2014. Semua pasien dilakukan penilaian APACHE II, SOFA, dan CSOFA. Uji analisis regresi logistik dilakukan untuk menilai pengaruh masing masing sub variabel terhadap mortalitas, dan selanjutnya mencari cut off point dari analisis kurva ROC untuk mendapatkan sensitifitas dan spesifisitas masing masing.
Hasil : Area under Receiver Operating Characteristic (AuROC) pada APACHE II, SOFA, dan CSOFA berturut turut didapatkan 0,892, 0,919, dan 0,9172. Missing value terbanyak didapatkan berturut turut pada SOFA, APACHE II, dan CSOFA sebesar 84,23%, 8,15%, dan 1,65%, dengan dominan sub variabel hepar (bilirubin). Uji regresi logistik memperlihatkan sub variabel neurologi, kardiovaskular, dan respirasi memberikan hubungan bermakna terhadap mortalitas dengan RO 4,58, 2,24, dan 1,47. Sub variabel lain yang berpengaruh antara lain AKI, sepsis, dan penyakit kronis dengan RO 8,14, 3,89 dan 2,42.
Simpulan : CSOFA lebih valid dalam memperkirakan mortalitas pasien di ICU RSUP Sanglah Denpasar, karena mempunyai nilai diskriminasi yang lebih baik dan missing value yang lebih sedikit dibandingkan dengan sistem skoring APACHE II dan SOFA
Article Metrics:
- Achary SP, Pradhan B, Marhatta N. Application of the SOFA score in predicting outcome in ICU patients with SIRS. Kathmandu University Medical journal. 2007;5:475-83
- Aftab H, Patil S, Parcells AL, Chamberlain RS. The Simplified Acute Physiology Score III is superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in predicting surgical and ICU mortality in the oldest old. Current Gerontology and Geriatrics Research. 2014;2014:1-9
- Bouch DC., Thompson JP. Severity scoring systems in the critically ill. Continuing Education in Anesthesia. Critical Care & Pain J. 2008;8(5):181-5
- Chiavone PA, Santos Sens YA. Evaluation of APACHE II system among Intensive Care Patients at Teaching Hospital. Sao Paulo Med J. 2003;12(92):53-7
- Sunaryo A, Ike SR, Bisri T. Perbandingan validasi APACHE II dan SOFA score untuk memperkirakan mortalitas pasien yang dirawat di ruang perawatan intensif. Majalah Kedokteran terapi Intensif. 2012;2:11-20
- Liu H, Li G, Cumberland WG, Wu T. Testing statistical significance of the area under a receiving operating curve for repeated mesures design with bootstrapping. J of data science. 2005;3:257-8
- Halim DA, Murni TW, Ike SR. Comparison of APACHE II, SOFA, and modified SOFA scores in predicting mortality of surgical patients in intensive care unit at Dr. Hasan Sadikin general hospital. Crit Care & Shock. 2009;12:157-69
- Grissom CK, Brown SM, Kuttler KG, Boltax JP. A Modified Sequential Organ Failure Assessment (MSOFA) for critical care triage. Disaster Med Public Health Prep. 2010;4:277-84
- Pandharipande PP, Shintani AK, Hagerman HE, Rice TW. Derivation and validation of SpO2/FiO2 ratio to impute for PaO2/FiO2 ratio in the respiratory component of the Sequential Organ Failure Assessment score. Crit Care Med. 2009;37:1317-21
- Rice TW, Wheeler A.P, Bernard GR, Hayden DL. Comparison of the SpO2/FiO2 and the PaO2/FiO2 ratio in patients with acute lung injury or ARDS. Chest. 2007;132:410-7
- Namendy-silva SA, Medina-silva MA, Barahona VGM, Torres JA. Application of modified sequential organ failure assessment score to critically ill patients. Braz J Med Biol Res. 2013;46(2):186-93
Last update: 2021-03-03 04:43:25
-
Organ failure of patients using ventilator based on the sequence organ failure assessment score (SOFA) admitted in Intensive Care Unit
Siti Rahmalia Hairani Damanik, Gamya Tri Utami, Sofiana Nurcahyati, Safri. Enfermería Clínica, 29 , 2019. doi: 10.1016/j.enfcli.2019.01.001
Last update: 2021-03-03 04:43:27
The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University as publisher of the journal. Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms, and any other similar reproductions, as well as translations.
JAI (Jurnal Anestesiologi Indonesia) and Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University and the Editors make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in JAI (Jurnal Anestesiologi Indonesia) are the sole and exclusive responsibility of their respective authors and advertisers.
The Copyright Transfer Form can be downloaded here:[Copyright Transfer Form JAI]. The copyright form should be signed originally and send to the Editorial Office in the form of original mail, scanned document:
Mochamat (Editor-in-Chief)
Editorial Office of JAI (Jurnal Anestesiologi Indonesia)
Department of Anesthesiology and Intensive Theraphy, Faculty of Medicine, Diponegoro University/ Dr. Kariadi General Hospital Medical Center (RSUP Dr. Kariadi)
Jl. Dr. Soetomo No. 16 Semarang, Central Java, Indonesia, 50231
Telp. : (024) 8444346
Email : janestesiolgo@gmail.com