Hubungan Pemberian Nutrisi Enteral Dini terhadap Mortalitas pada Pasien Perawatan PICU di RSUP Haji Adam Malik

Abstract

Objective: To determine the relationship of early enteral nutrition and mortality and length of stay, as well as the relationship of nutritional status and mortality in PICU care patients at Haji Adam Malik General Hospital. Methods: Cross-sectional study with data taken from the medical records of pediatric patients admitted to the PICU. Early and delayed enteral nutrition with mortality were analyzed with Chi Square test, while early and delayed enteral nutrition with the length of stay were analyzed with Mann Whitney test. Nutritional status with mortality was analyzed with Kruskal Wallis test. P value less than 0.05 was considered statistically significant. Results: From 36 subjects who were given early enteral nutrition, 11 subjects died during the stay in PICU, while 18 of 32 subjects who received delayed enteral nutrition died. Subjects who were given early enteral nutrition had an average stay of 7.72 days in PICU, meanwhile those who were not given early enteral nutrition had an average stay of 8.84 days. A statistical test of early enteral nutrition on mortality in PICU care patients gave a p value = 0.032 (<0.05) and OR=2.8, however, between early enteral nutrition and length of stay gave a p value of 0.448. 13 subjects admitted to PICU with good nutritional status were died during the stay and 18 subjects were discharged from PICU, 7 subjects with mild malnutrition died and 10 subjects were discharged from PICU, 9 subjects with severe malnutrition died and 10 subjects were discharged from PICU. There was only 1 overweight subject who was discharged from PICU. P value of statistical test between nutritional status and mortality was 0.820. From 19 subjects with organ dysfunctions, 14 subject died during the stay in PICU. From 49 subjects without organ dysfunctions, 15 died during the stay in PICU. A statistical test of organ dysfunctions on mortality in PICU care patients gave a p value = 0.001 (<0.05) and OR=6,3. Conclusion: Early enteral nutrition is associated with reduced mortality in patients treated in PICU Haji Adam Malik General Hospital. Patients who do not receive early enteral nutrition are 2.8 times likely to die during stay in PICU than those who receive early enteral nutrition. There is no association of early enteral nutrition with length of PICU stay, neither the association of nutritional status at PICU admission with mortality during PICU stay.