Faktor-Faktor yang Mempengaruhi Mortalitas pada Pasien Trauma Abdomen Pre-Operatif yang dilakukan Eksplorasi Laparotomi di RSUP H. Adam Malik Medan

Abstract

Background: Trauma is the most common cause of death in the fourth decade of life and is still a major public health problem in every country in all socioeconomic layers (Gad et al, 2012). Abdominal trauma was ranked third of all trauma and approximately 25% of cases require surgery (Hemmila, 2008). In Farah A study (2003) showed that the lactic acid and base excess are factors that affect mortality in major abdominal surgery. Objective: This study aimed to determine the factors that affect mortality in patients with pre- operative abdominal trauma were performed exploratory laparotomy in the Division of Surgical Digestive Department of Haji Adam Malik Medan Hospital. Methods: This study is a descriptive-analytic study was performed in all patients with a diagnosis of abdominal trauma who conducted exploratory laparotomy in the Division of Surgical Digestive Department of Haji Adam Malik Medan Hospital, from January 2010 to December 2014. Results: Of the 78 patients studied, the results obtained majority of male patients as many as 66 people (84.6%); the average temperature of 36.84° C; mean blood pH of 7.31 and base excess mean -4.74; PT mean 18.7; aPTT average of 34.75; blood lactic acid levels of 3.32 mmol/1. The majority of blunt trauma as many as 52 people (66.7%) and the mean time pre-hospital time 21.19 hours. Based on multiple logistic regression analysis was obtained three independent variables that significantly affect mortality in the multivariate analysis, namely BE (p = 0.002), lactic acid (p = 0.004) and pre-hospital time (p = 0.006). The independent variables were the most dominant effect on the mortality of patients with abdominal trauma is lactic acid levels with Exp (B) high of 3.886. Conclusion: The conclusion of this study, lactic acid is the most decisive factor of mortality in patients with pre-operative abdominal trauma were performed exploratory laparotomy.