Faktor-faktor yang Memengaruhi Pemanjangan Lama Rawat Intensif Pasien Atresia Bilier Pediatrik yang Menjalani Operasi Kasai di RSUP Dr. Sardjito

Muhammad Brian Ristianto, Yunita Widyastuti, Djayanti Sari

Abstract


Atresia bilier merupakan kelainan pada neonatus yang menyebabkan gagal hepar progresif dan kematian bila tidak ditangani. Operasi Kasai merupakan penanganan atresia bilier melalui pembuatan anastomosis untuk drainase empedu. Pemanjangan lama rawat pascaoperasi Kasai meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan menemukan faktor-faktor yang memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Penelitian ini merupakan studi observasional kohort retrospektif pada pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai di RSUP Dr. Sardjito dari 1 Januari 2017 hingga 31 Desember 2021. Terdapat 33 dari 52 sampel (64%) mengalami pemanjangan lama rawat intensif. Uji statistik dilakukan dengan uji regresi logistik univariat dan uji regresi logistik multivariat bagi parameter yang signifikan pada uji sebelumnya (p<0,25). Didapatkan sepsis (OR=39,2) dan malnutrisi (OR=7,55) signifikan memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Simpulan, Sepsis dan malnutrisi signifikan memengaruhi pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai masing-masing sebanyak 39 dan 7,5 kali.

 

Keywords


Atresia bilier; faktor-faktor yang berpengaruh; lama perawatan; operasi Kasai

Full Text:

PDF

References


  1. Bezerra JA, Wells RG, Mack CL, Karpen SJ, Hoofnagle JH, Doo E, dkk. Biliary atresia: clinical and research challenges for the twenty-first century. Hepatology. 2018;68(3):1163–73
  2. Trihono PP, Djer MM, Sjakti HA, Hendrarto TW, Prawitasari T. Best practices in pediatrics. 2013;136.
  3. Jacob R. Anaesthesia for biliary atresia and hepatectomy in paediatrics. Indian J Anaesth. 2012;56(5):479–84.
  4. Lee M, Chen SC-C, Yang H-Y, Huang J-H, Yeung C-Y, Lee H-C. Infant stool color card screening helps reduce the hospitalization rate and mortality of biliary atresia: a 14-year nationwide cohort study in Taiwan. Medicine (Baltimore). 2016;95(12):e3166
  5. Bromley PN, Rawlinson E, Harclerode Z, Bennet J. Developmental physiology of the liver, gastrointestinal tract, and renal system. Dalam: Andropoulos DB, Gregury GA, penyunting Gregory’s pediatric anesthesia. Churchill Livingstone John Wiley & Sons, Ltd. 2020.hlm 164–90.
  6. Marfil-Garza B, Belaunzaran P, Gulias-Herrero A, Camiro-Zúñigaet A, Caro Y, Kershenobich-Stalnikowitz D, dkk. Risk factors associated with prolonged hospital length-of-stay: 18-year retrospective study of hospitalizations in a tertiary healthcare center in Mexico. PLOS ONE. 2018;13:e0207203.
  7. Toptas M, Sengul Samanci N, Akkoc İ, Yucetas E, Cebeci E, Sen O,dkk. Factors affecting the length of stay in the intensive care unit: our clinical experience. BioMed Res Int.2018: e9438046.
  8. Garcia AV, Ladd MR, Crawford T, Culbreath K, Tetteh O, Alaish S, dkk. Analysis of risk factors for morbidity in children undergoing the Kasai procedure for biliary atresia. Pediatr Surg Int. 2018;34(8):837–44.
  9. Du M, Wang J, Tang Y, Jiang J, Chen G, Huang Y, dkk. Evaluation of perioperative complications in the management of biliary atresia. Front Pediatr. 2020;8:460.
  10. Rokhayati E, Setyoboedi B, Arief S. Aktivitas serum bilirubin pada pasien atresia bilier sebelum dan sesudah operasi kasai. Smart Medical Journal.2021;4(2):7.
  11. Edomwonyi NP, Ekwere IT, Egbekun R, Eluwa B. Anesthesia-related complications in children. Middle East J Anaesthesiol. 2006;18(5):915–27.
  12. Islam MA, Firoz AZM. Intra-operative & post-operative complications in pediatric anesthesia- A Prospective Observation Study. 2021;3:4.
  13. Zani A, Quaglia A, Hadzić N, Zuckerman M, Davenport M. Cytomegalovirus-associated biliary atresia: an aetiological and prognostic subgroup. J Pediatr Surg. 2015;50(10):1739–45.
  14. Rhu J, Jung S-M, Choe YH, Seo J-M, Lee S-K. PELD score and age as a prognostic index of biliary atresia patients undergoing Kasai portoenterostomy. Pediatr Surg Int. 2012;28(4):385–91.
  15. Ganigara A, Ramavakoda C, Bindu, Sanket B, Jadhav V, Aihole J. Anesthetic management and perioperative outcome of infants with biliary atresia: A retrospective review of 40 cases from a tertiary care pediatric institute in India. Indian J Clin Anesthesia. 2016;3(1):62–8.
  16. Lianti H, Kurnia N, Rinaldhy K, Aji A, Ismet MF, Amaliah R. Analysis of knowledge regarding biliary atresia among healthcare providers and laypersons in East Jakarta after educational intervention. ASEAN J Community Engagem. 2020;4(1):279–301.
  17. Bromley P, Bennett J. Anaesthesia for children with liver disease. Contin Educ Anaesth Crit Care Pain. 2014;14(5):207–12.
  18. Lee K, Kim J, Moon J, Ko J. Epidemiology of biliary atresia in Korea. J Korean Med Sci. 2017;32:656.
  19. Gunadi, Gunawan TA, Widiyanto G, Yuanita A, Mulyani NS, Makhmudi A. Liver transplant score for prediction of biliary atresia patients’ survival following Kasai procedure. BMC Res Notes. 2018; 11(1):381.
  20. Gad EH, Kamel Y, Salem TA-H, Ali M A-H, Sallam AN. Short- and long-term outcomes after Kasai operation for type III biliary atresia: twenty years of experience in a single tertiary Egyptian center-A retrospective cohort study. Ann Med Surg. 2021;62:302–14.
  21. Pratiwi FC, Widowati T, Prawirohartono EP. Comparison of nutritional status among children with biliary atresia according to age at the time of Kasai procedure. Paediatr Indones. 2019; 59(6):294–7.
  22. Arafah YF, Murni IK, Rusmawatiningtyas D. Predictors of prolonged stay in the pediatric intensive care unit. Paediatr Indones. 2020;60(1):37–41.
  23. Bezerra JA, Wells RG, Mack CL, Karpen JS, Hoofnagle JH, Doo E, dkk. Biliary atresia: clinical and research challenges for the twenty-first century. Hepatology 2018;68(3):1163–73.
  24. Qisthi SA, Saragih DSP, Sutowo DW, Sirait DN, Imelda P, Kencana SMS. 2020. Prognostic factors for survival of patients with biliary atresia following kasaisurgery. Kobe J Med Sci. 2020;66(2):56–60.
  25. Joliat G-R, Schoor A, Schäfer M, Demartines N, Hübnert N, Labgaa I. Postoperative decrease of albumin (ΔAlb) as early predictor of complications after gastrointestinal surgery: a systematic review. Perioper Med. 2022;11:7.




DOI: https://doi.org/10.15851/jap.v12n1.3411

Article Metrics

Abstract view : 252 times
PDF - 116 times


 

This Journal indexed by

                   

           


 
Creative Commons License
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 



View My Stats