Hubungan antara Karakteristik Klinis dan Laboratorium, dengan Luaran Pasien Difteri yang Dirawat di RSUP Haji Adam Malik Tahun 2020 – 2023

Abstract

Background: In 2017, diphtheria outbreaks occurred in several provinces in Indonesia. In North Sumatra, data on diphtheria cases are rarely published. Therefore, information is needed to assess the clinical and laboratory characteristics that are associated with increase in mortality of diphtheria. Objective: To analysed the relationship between clinical and laboratory characteristics, with the outcome of diphtheria patients hospitalized at Haji Adam Malik Hospital in 2020 - 2023. Methods: Retrospective cohort study to assess the association of clinical and laboratory characteristics with mortality. Research data was obtained from medical records of patient aged 1-18 years diagnosed with diphtheria clinically at H. Adam Malik Hospital Medan in the period January 2020 to December 2023. Statistical analysis using Fisher's Exact test, Odds Ratio and Nagelkerke R Square were done to evaluate demographic issues, clinical features, immunization status, complications, laboratory profile, and mortality. Results: A total of thirty seven subjects were recruited in this study. There was a significant association between clinical characteristics of myocarditis (p = 0.005) and airway obstruction (p = 0.003). There was a significant association between thrombocytopenia (p = 0.020) and positive culture results (p = 0.063) with mortality of diphtheria patients. Patients with airway obstruction were 26 times more likely to have increased in mortality compared to patients without airway obstruction (OR= 26, 95% IK = 2,478 - 272,816). Conclusion: There are association between clinical and laboratory characteristics with patient outcome. Complications of airway obstruction are associated with a 26 times greater risk of death compared to paediatric subjects without airway obstruction.