Perbandingan Nilai Prognostik Optical Nerve Sheath Diameter, Transcranial Doppler Pulsatility Index, dan Skor APACHE II terhadap Mortalitas di Ruang Intensif pada Pasien Pascabedah Otak

Radian Ahmad Halimi, Reza Widianto Sudjud, Indriasari Indriasari

Abstract


Skor Acute Physiology and Chronic Health Evaluation II (APACHE II) merupakan alat yang umum digunakan untuk menilai tingkat keparahan penyakit dan memprediksi mortalitas pasien di unit perawatan intensif (ICU), termasuk pasien bedah saraf. Pemeriksaan optic nerve sheath diameter (ONSD) dan transcranial doppler pulsatility index (TCD-PI) telah dikembangkan sebagai alat pemantauan noninvasif untuk mendeteksi komplikasi dan memperkirakan risiko kematian pada pasien dengan gangguan sistem saraf pusat. Penelitian ini merupakan studi observasional analitik prospektif yang bertujuan membandingkan nilai prediktif ONSD, TCD-PI, dan skor APACHE II terhadap mortalitas pasien pascabedah otak di ICU. Sebanyak 36 pasien diikutsertakan, dengan pemeriksaan dilakukan 12–24 jam pascabedah. Analisis dilakukan menggunakan area under the receiver operating characteristic curve (AUROC) untuk menilai kemampuan diskriminatif tiap-tiap variabel. Hasil menunjukkan bahwa ONSD memiliki AUROC tertinggi (0,824), dibanding dengan TCD-PI (0,786) dan skor APACHE II (0,808). Uji statistik DeLong menunjukkan bahwa ONSD secara signifikan lebih baik dibanding dengan TCD-PI (p=0,01), namun tidak berbeda bermakna dibanding dengan APACHE II (p=0,12). Simpulan, ONSD menunjukkan nilai prognostik yang lebih baik dalam memprediksi mortalitas pasien pascabedah otak dibandingkan TCD-PI dan setara dengan skor APACHE II.

 

Keywords


APACHE II, mortalitas, ONSD, TCD-PI, ICU

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References


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DOI: https://doi.org/10.15851/jap.v13n1.3966

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