Analisis Faktor-Faktor yang Mempengaruhi Lama Rawatan dan Mortalitas Pasien Pascaoperasi Bedah Digestif yang Dirawat di Intensive Care Unit RS Adam Malik Tahun 2023-2024

Abstract

Background. Postoperative digestive surgery patients often require intensive care unit management for close monitoring and stabilization after surgery. Variations in clinical status may influence the length of stay and mortality rates. Identifying factors associated with these outcomes is essential to improve the quality of care and clinical outcomes. Objective. To determine the factors associated with length of stay and mortality among postoperative digestive surgery patients admitted to the ICU of Adam Malik Hospital Medan in 2023–2024. Methods. This was an analytical observational study with a retrospective cross-sectional design. Samples were obtained using consecutive sampling from medical records of postoperative digestive surgery patients admitted to the ICU from 2023–2024. A total of 51 patients met the inclusion criteria. Variables examined included body mass index (BMI), preoperative albumin level, and ventilator use in relation to ICU length of stay and mortality. Results. A total of 51 patients were included, consisting of 37 males (72.5%) and 14 females (27.5%), with a mean age of 52.71 ± 16.13 years. Most patients had no comorbidities (86.3%), underwent open surgery (100%), and were diagnosed with malignancy (64.7%). The majority had normal BMI (84.3%) and preoperative hypoalbuminemia (68.6%). A total of 35 patients (68.6%) required ventilator support. The median ICU length of stay was 2.4 days, with IQR of 1.8–4.2 days, and the ICU mortality rate was 49%. There was no significant association between BMI (p=0.205), preoperative albumin levels (p=0.489), or ventilator use (p=0.193) with length of stay. However, preoperative albumin level (p=0.020) and ventilator use (p<0.001) were significantly associated with ICU mortality, whereas BMI was not (p=0.330). Conclusion. Preoperative albumin level and ventilator use were significantly associated with mortality in postoperative digestive surgery patients admitted to the ICU. Meanwhile, BMI, preoperative albumin level, and ventilator use showed no significant association with ICU length of stay.