Latar Belakang: Peningkatan insiden tukak peptikum perforasi (TPP) Divisi Bedah digestif RSUPN Dr. Cipto Mangunkusumo Jakarta. Selama enam bulan awal pandemi Covid-19, naik empat kali lipat, dibandingkan enam bulan sebelum pandemi Covid-19. Penelitian ini bertujuan untuk menilai peran stres psikologis sebagai faktor risiko tukak peptikum perforasi.Metodologi: Merupakan studi retrospektif potong lintang, membandingkan 2 kelompok subjek penelitian, TPP pandemi Covid-19 Maret 2020 hingga Maret 2021 dan non-pandemi Covid-19 Juli 2017 hingga Februari 2020. Data demografi, klinis, dan tingkat stres psikologis yang diukur dengan Perceived Stress Scale (PSS-10) merupakan variabel yang diperiksa. Hasil: Tercatat 53 TPP, 28 subjek pada pandemi, pria 11, wanita 17, rerata usia 63 tahun, pemakaian obat antiinflamasi nonsteroid atau jamu 80%, komorbid 92,8%, lama rawat 23,6 hari, morbiditas 78,5%, infeksi daerah operasi 17%, pneumonia 38,9%, dan mortalitas 46,4%. 25 subjek pada non-pandemi, pria 21, wanita 4, rerata usia 53 tahun, penggunaan obat antiinflamasi nonsteroid atau jamu 85%, komorbid 48%, rerata skor boey 1,3, PULP 6,8, ASA 3, lama rawat 16,2 hari, morbiditas 52%, infeksi daerah operasi 12%, pneumonia 36%, dan mortalitas 28%. Penilaian PSS-10 pada 37 subjek, pada pandemi, stres berat delapan, stres sedang tujuh, stres ringan empat. Pada non-pandemi stres berat satu, stres sedang delapan, stres ringan sembilan. Uji Fischer exact didapatkan perbedaan antara stres ringan-sedang dengan stres berat pada kedua kelompok, p = 0,019. Uji Spearman didapatkan korelasi moderat (rs = 0,422) antara stres psikologis dengan pandemi, p = 0,009.Simpulan: Pandemi Covid-19 memperberat stres psikologis, meningkatkan morbiditas dan mortalitas tukak peptikum perforasi.
Background: Increased incidence of perforated peptic ulcer (PPU) Digestive Surgery Division, Dr. Cipto Mangunkusumo Hospital, Jakarta. During early of six months Covid-19 pandemic, increased four times, compared to six months before Covid-19 pandemic. This study aims to evaluate the role of psychological stress as a risk factor for perforated peptic ulcer.Methodology: a cross-sectional retrospective study, compare 2 groups on the PPU subjects of COVID-19 pandemic March 2020 to March 2021 and non-pandemic Covid-19 July 2017 to February 2020. Demographic, clinical, and psychological stress data as measured by Perceived Stress Scale (PSS-10) were variables to be evaluated.Results: Registered 53 PPU, 28 subjects in Covid-19 pandemic, 11 males, 17 females, 63 years mean age, 80% used of nonsteroidal anti-inflammatory drugs or Indonesian herbs, 92.8% comorbidities, 23.6 days length of stay, 78,5% morbidity, 17% surgical site infection, 38.9% pneumonia, and 46,4% mortality. 25 subjects in non-pandemic, 21 males, 4 females, 53 years mean age, 85% non-steroidal anti-inflammatory drugs or Indonesian herbs, 48% comorbidity, 1.3 mean boey score, 6.8 PULP, 3 ASA, 16.2 days length of stay, 52% morbidity, 12% surgical site infection, 36% pneumonia, and 28% mortality. PSS-10 evaluated on 37 subjects, in pandemic, eight severe stress, seven moderate stress, four mild stress. In non-pandemic, one severe stress, eight moderate stress, and nine mild stress. Fischer's exact test found a difference between mild-moderate stress and severe stress in both groups, p = 0.019. Spearman's test found a moderate correlation (rs=0.422) between psychological stress and the pandemic, p = 0.009.Conclusion: Covid-19 pandemic exacerbates psychological stress, increasing morbidity and mortality of perforated peptic ulcer. |
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