Analisis Faktor Risiko Oxygenation Index, Oxygen Saturation Index, dan Rasio Pao2/Fio2 sebagai Prediktor Mortalitas Pasien Pneumonia COVID-19 dengan ARDS di Ruang Perawatan Intensif Isolasi Khusus RSUD Dr Soetomo

Samuel Hananiel Rory; Arie Utariani; Bambang Pujo Semedi

doi:10.15851/jap.v9n1.2275

Analisis Faktor Risiko Oxygenation Index, Oxygen Saturation Index, dan Rasio Pao2/Fio2 sebagai Prediktor Mortalitas Pasien Pneumonia COVID-19 dengan ARDS di Ruang Perawatan Intensif Isolasi Khusus RSUD Dr Soetomo

Samuel Hananiel Rory, Arie Utariani, Bambang Pujo Semedi

Abstract

Pada kasus berat, pneumonia COVID-19 terjadi perburukan secara cepat dan progresif yang menyebabkan ARDS. Pengukuran parameter oksigenasi seperti oxygenation index (OI) dan oxygen saturation index (OSI) pada beberapa penelitian menunjukkan superioritas dibanding dengan rasio PaO2/FiO2 dalam menilai status oksigenasi dan derajat keparahan ARDS. Penelitian ini bertujuan melakukan analisis faktor risiko OI, OSI, dan Rasio PaO2/FiO2 terhadap mortalitas pasien pneumonia COVID-19 dengan ARDS. Penelitian ini adalah penelitian analitik observaional dengan desain cohort-prospective terhadap pasien dewasa pneumonia COVID-19 dengan ARDS berdasar atas kriteria Berlin. Data perhitungan OI, OSI, dan rasio PaO2/FiO2 diambil pada 30 menit pertama pascapemasangan ventilator mekanik. Analisis regresi logistik digunakan untuk menganalisis faktor risiko OI, OSI, dan rasio PaO2/FiO2 terhadap mortalitas 28 hari pasien pneumonia COVID-19 dengan ARDS. Hasil penelitian didapatkan pada 77 pasien yang memenuhi kriteria inklusi dan tidak termasuk eksklusi, hanya variabel OI yang terbukti signifikan sebagai prediktor independen mortalitas dengan nilai p 0,043, sementara OSI dan rasio PaO2/FiO2 tidak signifikan. Dari ketiga variabel, OI mempunyai AUC tertinggi, yakni 0,935 dibanding dengan variabel OSI dan rasio PaO2/FiO2. Simpulan, OI terbukti sebagai prediktor independen mortalitas pada pasien pneumonia COVID-19 dengan ARDS.

Oxygen Index, Oxygenation Saturation Index, and Pao2/Fio2 Ratio as Predictors of Mortality in Pneumonia Covid-19 with ARDS Patients Treated in Intensive Isolated Care Unit

In severe COVID-19 cases, worsening of pneumonia occurs rapidly and leads to ARDS. Oxygenation parameters such as oxygenation index (OI) and oxygen saturation index (OSI) has been shown to be superior when compared to the PaO2/FiO2 ratio in assessing the oxygenation status and ARDS severity in some studies. Currently, there are limited studies that explore the prognostic values of these parameters in pneumonia COVID-19 with ARDS. This study aimed to analyze the OI, OSI, and PaO2/FiO2 Ratio as predictors of mortality in pneumonia COVID-19 with ARDS in patients treated in the intensive isolated care room. This was an observational analytic study conducted at dr. Soetomo Hospital, Indonesia, on adult patients who met the criteria for pneumonia COVID-19 with ARDS based on Berlin criteria. Data on OI, OSI, and PaO2/FiO2 were collected based on the results of measurements 30 minutes post-intubation and mechanical ventilation in these patients. Logistic regression analysis was used to analyze the OI, OSI, and PaO2/FiO2 as risk factors for 28 days mortality of pneumonia COVID-19 patients with ARDS. In a total of 77 patients eligible for the analyses, it was observed that OI was independently associated with hospital mortality (p 0.043) while OSI and PaO2/FiO2 ratio were not statistically significant. From these three variables, the AUC for mortality prediction was the greatest for OI (AUC 0.935, p<0.05). In conclusion, OI is the only one that is proven to be the independent predictor mortality with the highest sensitivity and specificity compared to the OSI and PaO2/FiO2 ratio for patients with pneumonia covid-19 with ARDS.

Keywords

ARDS, COVID-19, indeks oksigenasi, indeks saturasi oksigen, mortalitas, pneumonia, rasio PaO2 /FiO2

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DOI: https://doi.org/10.15851/jap.v9n1.2275