Skor prediktor kematian sepsis neonatorum awitan dini
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Latar belakang. Sepsis neonatorum awitan dini memiliki angka kematian tinggi dan sering memerlukan perawatan intensif. Beberapa sistem skor dikembangkan sebagai prediktor luaran, tetapi sering hanya pada berat lahir rendah atau memerlukan banyak pemeriksaan penunjang. Sistem skoring baru yang mudah, sederhana, cepat, dan dapat diaplikasikan akan memudahkan klinisi memprediksi luaran untuk pemilihan intervensi maupun konseling.
Tujuan. Mengembangkan model skor sebagai prediktor kematian sepsis neonatorum awitan dini.
Metode. Penelitian kohort retrospektif di RSUP Dr. Sardjito Yogyakarta menggunakan data sekunder bayi lahir bulan Januari 2014 – Mei 2015 dengan sepsis neonatorum awitan dini sesuai kriteria klinis. Bayi dieksklusi jika memiliki kelainan bawaan mayor atau data tidak lengkap. Pengembangan sistem skoring dengan metode Spiegelhalter Knill-Jones. Pembobotan skor digunakan nilai koefisien regresi logistik, sedangkan penentuan nilai titik potong skor digunakan kurva receiver operating characteristics (ROC).
Hasil. Seratus delapan subjek memenuhi kriteria inklusi dan eksklusi. Mortalitas sebesar 24%. Pengambilan skor 6 variabel yang memenuhi nilai LR, yaitu usia kehamilan (≤33 minggu: skor: 2, >33 minggu: skor -4), asfiksia (ya: 4, tidak: -5), leukopenia (≤5000: 10, >5000: 0), Trombositopenia (≤100.000: 5, >100.000: 0), absolute neutrophyl count (≤2000: 18, >2000: -1), dan biakan kuman (tumbuh: 10, tidak tumbuh: -3). Area under curve (AUC) adalah 83,8% (74,3%-92%). Titik potong pada skor 2 memiliki sensitivitas 84,6%, spesifisitas 64,4%, nilai ramal positif 43%, nilai ramal negatif 93%, likelihood ratio (LR) positif 2,39, dan LR negatif 0,24.
Kesimpulan. Skor ≥2 dapat memprediksi kematian sepsis neonatorum awitan dini.
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DOI: http://dx.doi.org/10.14238/sp18.2.2016.117-21
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