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"ABSTRAKPendahuluan. Pemilihan saat yang tepat untuk tindakan relaparotomi masih merupakan tantangan sehingga diperlukan pemeriksaan objektif sederhana untuk menentukan hal tersebut. Indeks Prediktif Reoperasi Abdominal IPRA diciptakan untuk menentukan saat relaparotomi. Tujuan penelitian adalah untuk mengkaji apakah IPRA dapat digunakan sebagai penentu saat relaparotomi di RSUPN dr. Cipto Mangunkusumo RSCM .Metode. Merupakan suatu penelitian deskriptif analitik potong lintang yang dilakukan pada penderita pascarelaparotomi tahun 2009-2015 di RSCM. Sampel berjumlah tiga puluh. Pada tiap sampel, delapan variabel penyusun IPRA diidentifikasi dan dievaluasi.Hasil. Kedelapan variabel penyusun IPRA kondisi emergensi, gagal ginjal, gagal nafas, nyeri perut, infeksi luka operasi, ileus, perubahan GCS, dan gejala baru pada hari keempat dapat diidentifikasi pada ketigapuluh sampel. Empat variabel dengan frekuensi tertinggi masing-masing nyeri perut, infeksi luka operasi, ileus, dan kondisi emergensi. Relaparotomi dapat dilakukan langsung pada penderita dengan skor 10 tanpa harus melakukan pemeriksaan penunjang.Konklusi. IPRA dapat digunakan sebagai suatu standar penilaian objektif sederhana dalam menentukan saat yang tepat untuk relaparotomi. Selain itu, relaparotomi dapat dilakukan pada penderita dengan skor 10 tanpa melakukan pemeriksaan penunjang. Kata kunci: IPRA, saat, relaparotom.

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ABSTRACTBackgroundDetermining the right timing of relaparotomy has always been a challenge and hence a simple objective value is required to do so. ARPI abdominal reoperative predictive index was created to decide when to reoperate. The purpose of this study was to ascertain whether ARPI could be applied as determinant of the timing of relaparotomy in our Hospital.MethodsA cross sectional descriptive study was done in 30 sample of patients who underwent relaparotomy from 2009 to 2015. Eight variables were identified and evaluated in each sample. ResultsEight variables composing ARPI can be identified thoroughly in each sample. Four variables with highest frequency were persistent symptoms on fourth postoperative day, abdominal pain, wound infection, and ileus. Relaparotomy can be performed in patients complaining abdominal pain appearing from second postoperative day and persisting for more than 4 day after operation.ConclusionsApplication of ARPI as a simple objective value to determine the right timing of relaparotomy was satisfactory. All variables are routinely checked and no additional unconventional examination needed. Furthermore, relaparotomy can be performed in patients complaining abdominal pain persisting for more than 4 days after operation which still needs further prospective research to validate. "

"[ABSTRAK Pendahuluan: Keputusan relaparotomi yang terlambat menambah morbiditas dan mortalitas. Keputusan on demand relaparotomy bersifat subjektif dari klinis, sehingga diperlukan pemeriksaan diagnostik tambahan dan alat untuk menentukan keputusan secara tepat, yaitu sistem skor. Metode penelitian: kasus kontrol dengan menggunakan 32 kasus on demand relaparotomy dan 64 kasus laparotomi, secara retrospektif. Hasil penelitian: Analisis perbedaan dua kelompok menunjukkan bahwa skor APACHE II tidak mempunyai perbedaan bermakna (p=0,144) sedangkan skor MPI dan ARPI mempunyai perbedaan yang bermakna (p<0,0001). Dari kurva ROC didaptkan APACHE II mempunyai AUC 59,2% dengan cut off point 10, MPI mempunyai AUC 86,4% dengan cut off point 20 dan ARPI mempunyai AUC 77,6% dengan cut off point 10. Kesimpulan: MPI dan ARPI bermanfaat sebagai penentu on demand relaparotomy.ABSTRACT Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.

Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.

Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.

Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.

Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. , Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.

Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ]"