Latar Belakang: Sirosis hati dengan dekompensasi akut merupakan masalahkesehatan dengan beban biaya yang besar dan berpengaruh negatif terhadapproduktivitas dan kualitas hidup. Belum diketahui sepenuhnya prediktor mortalitasdalam perawatan pasien sirosis hati dekompensasi akut di Indonesia.Tujuan: Mengetahui proporsi dan prediktor mortalitas dalam perawatan pasiensirosis hati dekompensasi akut di Rumah Sakit Cipto Mangunkusumo (RSCM).Metode: Studi kohort retrospektif berbasis data rekam medis pasien sirosis hatidekompensasi akut di RSCM (2016-2019). Analisis bivariat dan multivariat regresilogistik dilakukan untuk mengidentifikasi prediktor mortalitas dalam perawatan.Dua sistem skor dikembangkan berdasarkan identifikasi faktor-faktor tersebut.Hasil: 241 pasien dianalisis, sebagian besar adalah laki-laki (74,3%), menderitahepatitis B (38,6%) dan Child-Pugh B dan C (40% dan 38%). Perdarahan salurancerna ditemukan pada 171 pasien (70,95%) dan 29 pasien (12,03%) meninggaldalam perawatan. Prediktor independen mortalitas dalam perawatan adalah usia(adjusted OR:1,09 [1,03–1,14]; p=0,001), infeksi bakterial (adjusted OR: 6,25[2,31–16,92]; p<0,001), kadar bilirubin total (adjusted OR: 3,01 [1,85– 4,89];p<0,001) dan kadar kreatinin (adjusted OR: 2,70 [1,20–6,05]; p=0,016). Skorlogistik dan aditif untuk prediksi mortalitas dalam perawatan memiliki nilaiAUROC masing-masing 0,89 dan 0,86.Simpulan: Proporsi mortalitas dalam perawatan pasien sirosis hati dekompensasiakut di RSCM adalah 12,03%. Prediktor independen dari mortalitas dalamperawatan antara lain usia, adanya infeksi bakterial, kadar bilirubin dan kreatinin.Telah dikembangkan sistem skor prediksi mortalitas dalam perawatan pasien sirosishati dekompensasi akut.

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Background: Acutely decompensated liver cirrhosis is associated with a high

medical cost and negatively affects productivity and quality of life. Data on the

predictors of in-hospital mortality in acutely decompensated liver cirrhosis patients

in Indonesia is still limited.

Objective: To determine the proportion and predictors of in-hospital mortality in

acutely decompensated liver cirrhosis patients at Cipto Mangunkusumo Hospital.

Methods: Retrospective cohort study using the hospital database of acutely

decompensated liver cirrhosis at Cipto Mangunkusumo Hospital (2016-2019).

Bivariate and multivariate logistic regression analyses were performed to identify

predictors of in-hospital mortality. Two scoring systems were developed based on

the identified factors.

Results: 241 patients were analyzed, mostly male (74,3%), suffering from hepatitis

B (38.6%) and Child-Pugh B and C (40% and 38%). Gastrointestinal bleeding was

found in 171 patients (70,95%) and 29 patients (12,03%) died during

hospitalization. The independent predictors of in-hospital mortality were age

(adjusted OR: 1,09 [1,03-1,14]; p = 0,001), bacterial infection (adjusted OR: 6,25

[2,31-16,92]; p <0,001), total bilirubin levels (adjusted OR: 3,01 [1,85-4,89]; p

<0,001) and creatinine levels (adjusted OR: 2,70 [1,20-6,05]; p = 0,016). The

logistic and additive scoring system for predicting in-hospital mortality had

AUROC values of 0,89 and 0,86, respectively.

Conclusion: The proportion of in-hospital mortality in acutely decompensated liver

cirrhosis at Cipto Mangunkusumo Hospital was 12,03%. The independent

predictors of in-hospital mortality were age, bacterial infection, bilirubin, and

creatinine levels. The in-hospital mortality prediction scoring systems have been

developed for acutely decompensated liver cirrhosis.