Akurasi Skor Boey dan Peptic Ulcer Perforation (PULP) Sebagai Faktor Prediksi Mortalitas pada Pasien Ulkus Peptikum Perforasi di RSUP H. Adam Malik Medan

Abstract

Latar Belakang Setiap tahun penyakit ulkus peptikum mempengaruhi 4 juta orang di seluruh dunia. Sepuluh sampai duapuluh persen (10-20%) pada penderita ulkus peptikum terjadi komplikasi dan 2% -14% diantaranya terjadi ulkus peptikum perforasi. Angka kematian ulkus peptikum perforasi bervariasi dari 10% sampai 40%. Telah banyak dilaporkan beberapa sistem skoring untuk memprediksi hasil akhir pada pasien dengan perforasi ulkus peptikum, yaitu skor ASA, APACHE II (Acute Physiology and Chronic Health Evaluation II), Peptic Ulcer Perforation (PULP) score dan skor Boey. Tujuan penelitian ini adalah untuk mengetahui tingkat akurasi skor Boey dan PULP sebagai faktor prediksi mortalitas pada pasien ulkus peptikum perforasi di RSUP H. Adam Malik Medan. Metode Penelitian Penelitian ini bersifat analitik dengan desain retrospektif. Sampel yang diperoleh sebanyak 31 kasus. Data dikumpulkan melalui data rekam medis di RSUP H. Adam Malik Medan selama kurun waktu Januari 2013- Desember 2016. Data kemudian dilakukan analisis dengan menggunakan uji diagnosis tabel 2x2 dan ditampilkan kurva statistik Receiver Operating Characteristic (ROC). Hasil Penelitian Dari 31 sampel ulkus peptikum perforasi dijumpai rerata usia penderita adalah 60,1 tahun. Tingkat mortalitas sebesar 10 kasus (32,3%). Tingkat akurasi skor Boey untuk memprediksi mortalitas 91,7% dan akurasi skor PULP 88.6%. Kesimpulan Skor Boey dan PULP memiliki tingkat akurasi yang baik untuk memprediksi mortalitas pada pasien ulkus peptikum perforasi

Background Peptic ulcer disease affects 4 million people worldwide every year. Ten to twenty percent (10-20%) of patients with peptic ulcer had complications and 2% -14% of them experienced peptic ulcer perforation. The mortality rate of peptic ulcer perforation varies from 10% to 40%. Many scoring systems have been reported to predict the outcomes in patients with peptic ulcer perforation, ie ASA, APACHE II (Acute Physiology and Chronic Health Evaluation II), Peptic Ulcer Perforation (PULP) and Boey score. The purpose of this study was to determine the accuracy of Boey and PULP score as mortality predicting factor in peptic ulcer perforation patients at H. Adam Malik Medan Central General Hospital. Methods This study is analytic study with retrospective design. Samples were obtained from 31 cases. Data were collected through medical record at H. Adam Malik Medan Central General Hospital during the period of January 2013 - December 2016. The data were then analyzed by using 2x2 table diagnosis test and presented in the Receiver Operating Characteristic (ROC) statistic curve. Result From 31 samples of peptic ulcer perforation, the mean age was 60.1 years. Mortality rate was 10 cases (32.3%). Boey score's accuracy for predicting mortality is 91.7% and PULP score's accuracy is 88.6%. Conclusion Boey and PULP scores had a good level of accuracy to predict mortality in patients with peptic ulcer perforation.