ABSTRAK
Latar Belakang: Acute Respiratory Distress Syndrome (ARDS) merupakan salahsatu komplikasi progresivitas pneumonia, dengan risiko mortalitas dan kebutuhanventilasi mekanik yang sangat tinggi. Identifikasi risiko tinggi kejadian ARDSsangat penting untuk meningkatkan kewaspadaan tenaga medis dan upayapencegahan yang optimal.Tujuan: Mengetahui insidens ARDS pada pasien pneumonia dan mengetahuiapakah hipoalbuminemia dapat memprediksi kejadian ARDS dalam 14 hariperawatan.Metode: Studi kohort prospektif pasien pneumonia yang dirawat ruang rawat inapRSPUN dr. Cipto Mangunkusumo dalam periode 1 Agustus-31 Desember 2015.Hipoalbuminemia didefinisikan sebagai kadar albumin admisi < 2,5 g/dL. KejadianARDS dinilai berdasarkan pemenuhan kriteria Berlin dalam 14 hari perawatan.Hasil: Subjek pada penelitian ini sebanyak 120 pasien. Insidens kumulatif ARDSsebesar 17,5% (IK95% 10,7%-24,3%). Analisis bivariat menunjukkanhipoalbuminemia dapat memprediksi peningkatan risiko ARDS dalam 14 hariperawatan (RR 3,455; IK 95% 1,658-7,200). Terdapat hubungan bermakna antarasepsis saat admisi dan keseimbangan cairan dengan kejadian ARDS dalam 14 hariperawatan. Analisis multivariat menunjukkan RR hipoalbuminemia setelahpenyesuaian adalah 3,274 (IK 95% 1,495-5,528), dengan variabel perancu sepsissaat admisi.Simpulan: Insidens ARDS pasien pneumonia dalam 14 hari perawatan adalah17,5%. Hipoalbuminemia dapat memprediksi peningkatan risiko kejadian ARDSdalam 14 hari perawatan pasien pneumonia.

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ABSTRACT
Background: Acute Respiratory Distress Syndrome (ARDS) is one of complicationfor pneumonia progression, it is associated with higher risk of mortality andincreased need for mechanical ventilation. Identification of patients with high riskof developing ARDS is essential to increase physician alertness and ensure optimalprevention.Purpose: To obtained information about incidence of ARDS in pneumoniadiagnosed patients, and if hypoalbuminemia can predict occurrence of ARDS in 14days after diagnosed pneumonia.Method: Prospective cohort study in pneumonia diagnosed patients admitted inAugust until 31 December 2015, with 14 days of observation, all patient is beingtreated in medical ward unit of Cipto Mangunkusumo Hospital. Hypoalbuminemiais defined as albumin level below 2,5 g/dL and ARDS is defined by Berlin criteria.Result: The study has enrolled 120 patient. Cumulative incidence of ARDS is 17,5%(IK95% 10,7%-24,3%). Bivariate analysis showed hypoalbuminemia could predictincreased risk of ARDS in 14 days after diagnosed pneumonia (RR 3,455; IK 95%1,658-7,200). There is significant relationship between sepsis at time of admissionand mean fluid balance. Multivariate analysis shows adjusted RR 3,274 (IK 95%1,495-5,528), with sepsis at time of admission as a confounder.Conclusion: Cumulative incidence of ARDS in pneumonia diagnosed patient after14 days is 17,5%. Hypoalbuminemia could predict increased risk of ARDS in 14days of treatment in pneumonia diagnosed patients.Keyword: hypoalbuminemia; acute respiratory distress syndrome; pneumonia