Korelasi Skala Revised Trauma Score (RTS) dan National Early Warning Score (News) Terhadap Prognosis Pasien Trauma di Instalasi Gawat Darurat Rumah Sakit Umum Pusat Haji Adam Malik Medan
| Main Author: | Prastia |
|---|---|
| Other Authors: | Hanafie, Achsanuddin, Harto, Soejat |
| Format: | Masters application/pdf |
| Bahasa: | ind |
| Terbitan: |
Universitas Sumatera Utara
, 2019
|
| Subjects: | |
| Online Access: |
http://repositori.usu.ac.id/handle/123456789/15231 |
Daftar Isi:
- 83 Halaman
- Pendahuluan: Trauma merupakan salah satu masalah kesehatan di berbagai negara terlepas dari perkembangan sosial ekonominya. Trauma terus menjadi masalah kesehatan yang meningkatkan laju morbiditas dan mortalitas seiring dengan berkembangnya teknologi, meningkatnya kecelakaan dan tindakan kekerasan. Sistem penilaian untuk pasien trauma telah banyak digunakan dan sistem ini terus ditingkatkan untuk menangani terapi pasien trauma lebih efisien. Tujuan: Untuk menilai hubungan penggunaan Revised Trauma Score (RTS) dan National Early Warning Score (NEWS) terhadap prognosis pasien trauma Metode: Penelitian cross sectional dilakukan dari bulan Februari hingga Maret 2019 di Rumah Sakit Umum Haji Adam Malik. Populasi penelitian dibawa ke Instalasi Gawat Darurat (IGD) dari tempat kejadian dan bersedia untuk mengikuti penelitian. Data yang dibutuhkan untuk penelitian dicatat pada satu jam pertama pasien dirawat di IGD. Data terdiri dari tujuh variabel: tingkat kesadaran, tekanan darah sistolik, frekuensi nadi, frekuensi nafas, saturasi oksigen, penggunaan oksigen tambahan dan temperatur. Nilai RTS dan NEWS dicatat pada jam pertama. Nilai RTS dan NEWS juga dicatat pada hari pertama, kedua, ketiga dan keempat. Hubungan antara nilai RTS dan NEWS pasien yang hidup dan meninggal dibandingkan, dan hubungan nilai RTS dan NEWS terhadap prognosis di hari pertama dan keempat juga dinilai dengan analisa statistik. Hasil: Dari 62 sampel, 44 sampel (71%) merupakan laki-laki. Nilai rerata RTS pasien yang hidup sebesar 7,54+0,58 dan pada pasien yang meninggal sebesar 5,65+1,12. Nilai rerata NEWS pasien yang hidup sebesar 3,42+3,661 dan pada pasien yang meninggal sebesar 12,44+3,321. Terdapat perbedaan yang signifikan secara statistik antara nilai RTS dan NEWS pasien yang hidup dan yang meninggal (p<0,05). Pada hari pertama, terdapat korelasi negatif, kuat dan signifikan antara RTS dan kematian, dan korelasi positif, kuat dan signifikan antara NEWS dan kematian. Pada hari keempat, terdapat korelasi negatif, kuat dan signifikan antara RTS dan kematian, dan korelasi positif, kuat dan signifikan antara NEWS dan kematian. Kesimpulan: Terdapat perbedaan yang signifikan antara nilai RTS dan NEWS pada pasien yang hidup dan meninggal. Baik RTS maupun NEWS mempunyai korelasi yang kuat dan signifikan terhadap kematian pada hari pertama dan keempat. Dapat disimpulkan bahwa sistem penilaian ini mempunyai peran yang signifikan terhadap prognosis pasien.
- Introduction: Trauma is one of the main health problems in every country regardless of the level of socio-economic development. It continues to be a significant health problem that increases mortality and morbidity rates due to developments in technology, accidents and incidents of violence. Scoring systems for trauma patients have been used and these systems are constantly being improved in order to manage the diagnosis and treatment of trauma patients more efficiently. Objective: To assess the correlation of the use of Revised Trauma Score (RTS) and National Early Warning Score (NEWS) on prognosis in patients with trauma. Method: Cross-sectional study was conducted from February to March 2019 at the Haji Adam Malik General Hospital. The population of the study were brought to the Emergency Room (ER) room from the accident scene and agreed to participate in the study. The data needed for study were recorded within the first hour after the patient was first treated at ER. The data consisted of seven variables: level of consciousness, systolic blood pressure, heart rate, respiratory rate, oxygen saturation, use of supplemental oxygen and temperature. RTS and NEWS were measured and recorded in the first hour. RTS and NEWS were also measured and recorded on the first, second, third and fourth days. The relationships between RTS and NEWS of patients who died and who survived were compared, and the relationships between RTS and NEWS and prognosis on first day - fourth day were identified using statistical analysis. Results: Of 62 samples, 44 samples (71%) were male. The mean RTS value was 7,54+0,58 for patients who survived and 5,65+1,12 for patients who died. The mean NEWS value was 3,42+3,661 for patients who survived and 12,44+3,321 for patients who died. There was a statistically significant difference in RTS and NEWS of patients who died and who survived (p<0.05). On day one, there was a negative, strong and significant correlation between death and RTS, and a positive, strong and significant correlation between death and NEWS. There was a negative, strong and significant correlation between death and RTS, and a positive, strong and significant correlation between death and NEWS on day four as well. Conclusions: There was a statistically significant difference in RTS and NEWS of patients who died and who survived. Both RTS and NEWS had strong and significant correlation with death on day one and four. It can be said that these scoring systems had a significant role in the prognoses of patients.