Perbandingan Skor HARKIT dengan Skor Society of Thoracic Surgeons (STS) dalam Memprediksi Tingkat Mortalitas Pasien Paska Operasi Katup di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Background. Heart valve disease is a major contributor to increased mortality. In 2021, the HARKIT (Harapan Kita) score has been validated so that it can be seen the difference between the HARKIT score and the Society of Thoracic Surgeons (STS) score in predicting mortality rates in patients after heart valve surgery. Aim. To determine the comparison of the HARKIT score system with the STS score in predicting mortality rates in post-valve surgery patients at the H. Adam Malik Hospital Medan. Methods. This study is an analytic observational study with a cross-sectional approach method. The sample of this study were patients after heart valve surgery at the Haji Adam Malik Medan Hospital from January 2022-April 2023. The data used is obtained from patient medical record. Based on the Slovin formula and purposive sampling technique, 63 patients was collected. Data were analyzed univariate, bivariate, and prognosis test using the ROC curve. Results. A total of 63 patients, 8 patients experienced mortality after heart valve surgery. NYHA fc, hypertension, CCT, and concomitant TVR had an association with patient mortality. The HARKIT score system has good analytical power and very strong discriminant (H-L test P=0.646; AUC=0.916; 95% CI=0.794-1.000, while the STS score has poor analytical power (H-L test P=0.002) but has moderate discriminant (AUC=0.798; 95% CI=0.632-0.964). Conclusion. The HARKIT score (AUC 91.6%) is more accurate than the STS score (AUC 79.8%) in predicting the mortality rate of post-valve surgery patients at Haji Adam Malik Hospital Medan