Angka Mortalitas dan Faktor Risiko pada Pasien Geriatri yang Menjalani Operasi Emergensi Akut Abdomen  di RSUP Dr. Hasan Sadikin Bandung Tahun 2014−2015

Donny Prasetyo Priyatmoko; Reza Widianto Sudjud; Rudi Kurniadi Kadarsah

doi:10.15851/jap.v5n2.1109

Angka Mortalitas dan Faktor Risiko pada Pasien Geriatri yang Menjalani Operasi Emergensi Akut Abdomen di RSUP Dr. Hasan Sadikin Bandung Tahun 2014−2015

Donny Prasetyo Priyatmoko, Reza Widianto Sudjud, Rudi Kurniadi Kadarsah

Abstract

Geriatri memiliki kekhususan yang perlu diperhatikan dalam bidang anestesi dan tindakan operasi karena terdapat kemunduran sistem fisiologis dan farmakologis sejalan dengan penambahan usia. Penelitian di Yunani tahun 2007 menjelaskan bahwa angka mortalitas akibat tindakan operasi setelah usia 65 tahun menjadi 3 kali lipat dibanding dengan usia 18−40 tahun. Angka mortalitas geriatri tahun 2007 pada operasi elektif sebesar 5%, sedangkan operasi emergensi sebesar 10%. Tujuan penelitian ini adalah memperoleh angka mortalitas dan faktor risiko pada pasien geriatri yang menjalani operasi emergensi akut abdomen tahun 2014−2015. Tipe penelitian ini merupakan deskriptif dengan pendekatan retrospektif terhadap 180 subjek penelitian yang diambil di bagian rekam medis sejak Juli−Oktober 2016 pada pasien geriatri yang menjalani operasi emergensi akut abdomen di RSUP Dr. Hasan Sadikin Bandung tahun 2014−2015. Hasil penelitian ini memperlihatkan angka mortalitas sebesar 9% dengan faktor penyebab mortalitas paling dominan adalah syok sepsis sebesar 50%. Faktor predisposisi disebabkan oleh indeks massa tubuh <18,5 kg/m² sebesar 56,3%, diagnosis primer tumor intestinal sebesar 31,3%, penyakit penyerta diabetes melitus sebesar 31,3%, sepsis sebesar 93,8%, hipoalbumin sebesar 56,3% dan status fisik ASA 4E sebesar 62,5%. Simpulan, faktor presipitasi disebabkan oleh waktu respons penanganan >6 jam sebesar 93,8% dan komplikasi pascaoperasi severe sepsis disertai pneumonia sebesar 50%.

Kata kunci: Akut abdomen, angka mortalitas, geriatri, operasi emergensi

Mortality Rate and Risk Factor in Geriatric Patients Undergo Emergency Surgery for Acute Abdoment in Dr. Hasan Sadikin Hospital Bandung in 2014−2015

Geriatric has special anesthetic and surgical consideration because of reducing physiologic function and pharmacodynamic as the age increase. A study in Greece in 2007 shows that surgery in patient more than 65 year old has three times mortality rate than 18–40 years old patients. Geriatric mortality rate in 2007 undergo elective surgery is 5%, while the emergency surgery 10%. Purpose of this study was to obtain mortality rate and risk factor in geriatric patients underwent emergency surgery for acute abdomen in 2014−2015. This was a descriptive retrospective study of 180 subjects taken from the medical records in July to October, 2016 in geriatric patients underwent emergency surgery for acute abdomen at the Dr. Hasan Sadikin hospital in 2014−2015. Results of this study showed a mortality rate of 9%, with most dominant factors that cause mortality was septic shock (50%). Predisposing factors was the body mass index <18.5 kg/m² (56.3%), the diagnosis of primary tumor intestinal amounted to 31.3%, comorbidities of diabetes mellitus at 31.3%, sepsis (93.8%), hipoalbumin (56.3%) and ASA physical status 4E (62.5%). In conclution, precipitation factors caused by response time >6 hours (93.8%) and postoperative complications of severe sepsis with pneumonia (50%).

Key words: Acute abdomen, emergency surgery, geriatrics, mortality rate

Keywords

Akut abdomen, angka mortalitas, geriatri, operasi emergensi

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DOI: https://doi.org/10.15851/jap.v5n2.1109