Akurasi Kriteria Nadas dalam Membantu Menegakkan Diagnosis pada Anak yang Dicurigai Memiliki Penyakit Jantung Bawaan

Abstract

Background : Majority of congenital heart disease are diagnosed during evaluation of a murmur detected either during a routine follow-up or while assessment during an intercurrent illness. Clinical differentiation between pathologic and innocent murmurs would be important to identify those children who need further evaluation. Nadas criteria can be used to differentiate pathologic from innocent murmurs Objective : The aim of the study was to assess the accuracy of the Nadas criteria in helping to diagnose disease in children suspected of having congenital heart disease. Methodology : This was a diagnostic study with a cross-sectional approach. Inclusion criteria were children aged 1 month to 12 years from history and physical examination, there was a history of reccurent ARI, poor nutritional status , murmur were found, with/without cyanosis who attended the outpatient cardiology pediatric at Haji Adam Malik General Hospital between Januari - july 2021. Data analysis was created using IBM SPSS Statistics version 25 program. Results : The total number of participants was 70 children which were divided into 60 children (85.71%) with CHD and 10 children (14.29%) not with CHD. There were 38 children (63.33%) in the group of children aged less than 5 years with CHD. All CHD patients had poor nutritional status and 53 children (88.33%) of CHD patients had a history of recurrent ARI. A grade 3 or higher systolic murmur was found in 47 children (78.33%) of patients with CHD. Abnormal S2 occurred in 33 children (55%) with CHD. All children with CHD were detected with an abnormal ECG. Abnormal chest X-ray was found in 48 children (80%) with CHD. Conclusion : NADAS criteria can be used when score at 3 (1 major + 2 minor) with accuracy 87.14%, AUC value is 0.842, sensitivity of 88.33% and specificity was 80%