Nilai Diagnostik Sistem Penilaian POPS (Paediatric Observational Priority Score) dan EWSS (Early Warning Scoring System) dalam Memprediksi Rawat Inap Pasien Anak di Instalasi Gawat Darurat Rumah Sakit Umum Pusat Haji Adam Malik

Abstract

BACKGROUND: Doctors must be able to quickly and accurately assess clinical condition of patients, especially in the emergency rooms. An easy scoring system but producing meaningful clinical conclusions is the reason for creating various scoring systems. Includes a scoring system for predicting the admission status of patients. AIM : To determine the diagnostic value of POPS and EWSS in predicting the admission status of pediatric patients who came to the emergency department. METHODS: Diagnostic tests for POPS and EWSS were done to predict the admission status of pediatric patients in the emergency department of Haji Adam Malik general hospital from May to October 2020. Subjects aged 1 month to 18 years were excluded if they left the emergency department prior to assessment, had trauma cases, died, inpatients due to social indications, and patients who came only to continue therapy were also excluded. POPS and EWSS assessments were carried out by the researcher and the admission status of the patients were determined by the doctor in charge in the emergency department. RESULT: There were 119 children meeting the inclusion and exclusion criteria. POPS score ≥3 had sensitivity 82.65%, specificity 85.71%, and AUC 0.88 (p <0.001). EWSS score ≥2 had sensitivity 83.67%, specificity 71.43%, and AUC 0.83 (p <0.001). CONCLUSION: POPS and EWSS had good diagnostic values in predicting the admission status of pediatric patients in the emergency department. POPS has a slightly higher diagnostic value than EWSS.

ABSTRAK Latar Belakang: Saat pasien anak datang ke ruang emergensi, dokter harus dapat menilai kondisi klinis pasien secara cepat dan akurat. Sistem penilaian yang mudah namun menghasilkan simpulan klinis yang bermakna menjadi alasan dibuatnya berbagai sistem penilaian. Termasuk sistem penilaian yang memiliki akurasi baik dalam memprediksi kebutuhan pasien untuk rawat inap atau rawat jalan. Tujuan: Untuk mengetahui nilai diagnostik POPS dan EWSS dalam memprediksi rawat inap pasien anak di instalasi gawat darurat. Metode: Uji diagnostik sistem penilaian POPS dan EWSS dalam memprediksi rawat inap pasien anak yang datang ke instalasi gawat darurat Rumah Sakit Umum Pusat Haji Adam Malik, Medan dalam kurun waktu Mei-Oktober 2020. Subyek usia 1 bulan-18 tahun yang dieksklusikan jika meninggalkan instalasi gawat darurat sebelum dilakukan penilaian, berobat jalan atas permintaan sendiri, kasus trauma, rawat inap atas indikasi sosial, meninggal dunia, atau yang datang hanya untuk melanjutkan terapi. Penilaian POPS dan EWSS dilakukan oleh peneliti dan status admisi ditentukan oleh dokter yang bertugas di instalasi gawat darurat. Hasil: Subyek penelitian sebanyak 119 anak yang memenuhi kriteria inklusi dan eksklusi. Skor POPS ≥3 memiliki sensitivitas 82,65%, spesifisitas 85,71%, dan AUC 0,88 (p<0,001). Skor EWSS ≥2 memiliki sensitivitas 83,67%, spesifisitas 71,43%, dan AUC 0,83 (p<0,001). Kesimpulan: Sistem penilaian POPS dan EWSS memiliki nilai diagnostik yang baik dalam memprediksi rawat inap pasien anak di instalasi gawat darurat dan POPS memiliki nilai diagnostik sedikit lebih tinggi dibandingkan EWSS.