Perbandingan Penggunaan Pediatric Index of Mortality 2 (PIM2) dan Skor Pediatric Logistic Organ Dysfunction (PELOD), Untuk memprediksi kematian pasien sakit kritis pada anak
Sari
Latar belakang. Penilaian derajat kesakitan (severity score of illness) telah dikembangkan sejalan dengan meningkatnya
perhatian terhadap evaluasi dan pemantauan pelayanan kesehatan. Skor yang telah dikembangkan
untuk anak adalah pediatric logistic organ dysfunction, pediatric risk of mortality, dan pediatric index of
mortality.
Tujuan. Membandingkan ketepatan pediatric index of mortality-2 dengan skor pediatric logistic organ
dysfunction dalam memprediksi kematian pasien sakit kritis pada anak.
Metode. Rancangan observasi longitudinal dengan subjek penelitian anak yang menderita sakit kritis, dirawat
di Bagian Ilmu Kesehatan Anak RSHS pada bulan Februari-Mei 2008. Dilakukan anamnesis, pemeriksaan
fisis, dan laboratorium untuk mendapatkan pediatric index of mortality 2 dan skor pediatric logistic organ
dysfunction. Analisis statistik dengan menggunakan receiver operating characteristic (ROC) untuk menilai
diskriminasi dan Hosmer-Lemeshow goodness-of-fit untuk menilai kalibrasi.
Hasil. Didapatkan 1215 anak berobat ke Bagian Ilmu Kesehatan Anak RS Hasan Sadikin Bandung, 120
di antaranya merupakan pasien kritis. Pediatric index of mortality 2 memberikan hasil diskriminasi yang
lebih baik (ROC 0,783; 95% CI 0,688–0,878) dibandingkan dengan pediatric logistic organ dysfunction
(ROC 0,706; 95% CI 0,592–0,820). Pediatric index of mortality-2 memberikan hasil kalibrasi yang baik
(Hosmer-Lemeshow goodness-of-fit test p=0,33; SMR 0,85) dibandingkan pediatric logistic organ dysfunction
(p=0,00; SMR 1,37). PIM2 dan skor PELOD mempunyai korelasi positif dihitung dengan menggunakan
Spearman’s correlation, r=0,288 (p=0,001).
Kesimpulan. Pediatric index of mortality-2 memiliki kemampuan diskriminasi dan kalibrasi lebih baik
dibandingkan dengan pediatric logistic organ dysfunction.
Kata Kunci
Teks Lengkap:
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DOI: http://dx.doi.org/10.14238/sp10.4.2008.262-7
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