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.
Background: Acutely decompensated liver cirrhosis is associated with a highmedical cost and negatively affects productivity and quality of life. Data on thepredictors of in-hospital mortality in acutely decompensated liver cirrhosis patientsin Indonesia is still limited.Objective: To determine the proportion and predictors of in-hospital mortality inacutely decompensated liver cirrhosis patients at Cipto Mangunkusumo Hospital.Methods: Retrospective cohort study using the hospital database of acutelydecompensated liver cirrhosis at Cipto Mangunkusumo Hospital (2016-2019).Bivariate and multivariate logistic regression analyses were performed to identifypredictors of in-hospital mortality. Two scoring systems were developed based onthe identified factors.Results: 241 patients were analyzed, mostly male (74,3%), suffering from hepatitisB (38.6%) and Child-Pugh B and C (40% and 38%). Gastrointestinal bleeding wasfound in 171 patients (70,95%) and 29 patients (12,03%) died duringhospitalization. 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). Thelogistic and additive scoring system for predicting in-hospital mortality hadAUROC values of 0,89 and 0,86, respectively.Conclusion: The proportion of in-hospital mortality in acutely decompensated livercirrhosis at Cipto Mangunkusumo Hospital was 12,03%. The independentpredictors of in-hospital mortality were age, bacterial infection, bilirubin, andcreatinine levels. The in-hospital mortality prediction scoring systems have beendeveloped for acutely decompensated liver cirrhosis. |
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