Perbandingan Skor DECAF dengan Skor BAP-65 terhadap Kematian dalam Tiga Puluh Hari pada Pasien PPOK Eksaserbasi Akut di RSUP H. Adam Malik Medan

Siti Taqwa Fitria Lubis, E. N. Keliat, Alwinsyah Abidin

Abstract


Pada penderita penyakit paru obstruksi kronik (PPOK) eksaserbasi akut, penilaian derajat keparahan pada awal masuk penting dalam menentukan risiko kematian rawat inap rumah sakit, memutuskan perawatan bangsal atau Intensive Care Uni,t dan penatalaksanaan selanjutnya. Skor Dyspnoea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) dan skor elevated BUN, Altered mental status, Pulse 109 beats/min, age >65 years (BAP-65) dapat digunakan sebagai alat prognostik. Penelitian ini bertujuan membandingkan skor DECAF dengan skor BAP-65 memprediksi kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Penelitian dengan desain kohort, subjek adalah pasien PPOK eksaserbasi akut di Instalasi Gawat Darurat dan rawat inap RSUP H. Adam Malik Medan, pada bulan Februari–Juni 2013. Dinilai skor DECAF dan skor BAP-65. Dihitung sensitivitas dan spesifisitas kedua skor dan dibandingkan kekuatannya. Sebanyak 40 subjek direkrut, rata-rata (±SB) usia 61,07±12,42 tahun. Sembilan subjek (23%) meninggal saat penelitian. Uji chi-kuadrat mendapatkan hasil signifikan skor DECAF p 0,003 dan skor BAP-65 p=0,0026. Sensitivitas dan spesifisitas skor DECAF dan skor BAP-65, masing-masing 100% dan 16%, 100% dan 39%. Simpulan, skor DECAF dan skor BAP-65 memiliki hubungan dengan kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Tingginya sensitivitas dan rendahnya spesifisitas menyebabkan kedua skor ini belum dapat digunakan sebagai alat prognostik. Diperlukan penelitian dengan subjek yang lebih besar untuk mendapatkan keakuratan kematian. [MKB. 2016;48(1):7–14]

Kata kunci: PPOK eksaserbasi akut, prognosis, skor BAP-65, skor DECAF


Comparison between DECAF Score and BAP-65 Score in Predicting Thirty Days Mortality in Acute Exacerbations COPD Patients in H. Adam Malik General Hospital

Abstract

The assessment of severity level in patient with acute exacerbation chronic obstructive pulmonary disease (AECOPD) at early admission is important to determine the risk of in-hospital mortality, to decide hospitalization or requirement of Intensive Care Unit setting and further management. Dyspnea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) score, and elevated BUN. Altered mental status, pulse 109 beats/min, age >65 years (BAP-65) can be used as prognostic tools. The aim of this study was to investigate the comparison between DECAF score and BAP-65 score in predicting 30 days-mortality in AECOPD patients. This was a cohort study, subjects were AECOPD patients in emergency unit and inpatient in H. Adam Malik General Hospital, from February to June 2013. DECAF score and BAP-65 score were assessed. We calculated sensitivity and specificity of both scores to compare the stronger predictor. Fourty subjects were recruited, mean (±SD) age was 61.07±12.42 years. Nine subjects (23%) died during the study. This study presented significant result with p=0,003 for DECAF score and p=0,0026 for BAP-65 score, using chi-square test. Sensitivity and specificity of DECAF score and BAP-65 score were 100% and 16%, 100% and 39%, respectively. In conclusion, DECAF score and BAP-65 score have correlations with 30-days mortality in AECOPD patients. High sensitivity and low specificity prevent the use of these scores as prognostic tools. A larger study is required to determine the accuracy on mortality. [MKB. 2016;48(1):7–14]

Key words: Acute exacerbation COPD, BAP-65 score, DECAF score, prognostic

 

DOI: 10.15395/mkb.v48n1.727


Keywords


PPOK eksaserbasi akut, prognosis, skor BAP-65, skor DECAF

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