Analisis Survival dan Faktor yang Memengaruhi Kematian Penyakit Jantung Koroner di RSUP H. Adam Malik Medan

Abstract

Coronary heart disease (CHD) is one of the cardiovascular diseases and the main cause of death throughout the world. Based on WHO data, CHD is the first cause of death worldwide from 2000 to 2019. CHD is the second biggest cause of death in Indonesia (Age-standardised years of life lost (YLL) rate 2735 per 100,000 population). The average death rate due to CHD in North Sumatra exceeds the national average (Age-standardised years of life lost (YLL) rate of 3014 per 100,000 population. The aim of this study is to determine differences in median survival and factors that influence death in people with coronary heart disease based on history smoking, hypertension, diabetes, obesity, dyslipidemia and stress. The research method used a prospective cohort design with a sample size of 87 patients. This research was conducted at Haji Adam Malik Hospital Medan from June 2023 to January 2024. The population of this study were all coronary heart disease patients who were hospitalized at H. Adam Malik General Hospital Medan. The sample of this study was a study population that met the inclusion and exclusion criteria. Data analysis used SPSS. The results showed that smoking history (p=0,013; RR 6,545; 95% CI 1,479-28,977) dyslipidemia (p=0,035; RR 8,795; 95% CI 1,164-66,489), diabetes (p=0,016; RR 6,235; 95%CI 1,407-27,263), and stress (p<0,001; RR 12,091; 95%CI 4,313-33,891) have a significant effect on coronary heart disease mortality. Cox regression analysis showed that diabetes (p=0,032; HR 5,519; 95% CI 1,160 – 26,260), and stress (p=<0,001; HR 20,721; 95% CI 4,226 – 101,610) had a significant effect on differences in CHD survival. Stress levels is the factor that most influences CHD mortality and survival. People are expected not to smoke, manage stress well, and control diabetes and lipid levels to reduce deaths due to CHD.