Skor Prediksi Kematian Pneumonia pada Anak Usia di Bawah Lima Tahun
Sari
Latar belakang. Pneumonia merupakan penyebab utama kematian pada anak usia di bawah lima tahun di negara berkembang. Pengembangan sistem skor yang sederhana untuk memprediksi kematian pada pneumonia dapat meningkatkan kualitas pelayanan dan menurunkan angka kematian anak akibat pneumonia.
Tujuan. Menyusun skor prediksi kematian pada anak dengan pneumonia.
Metode. Penelitian kohort retrospektif pada anak (umur 2 bulan sampai 5 tahun) yang dirawat di RSUP Dr. Sardjito dengan pneumonia sejak Januari 2009 sampai Desember 2014. Anak dengan rekam medis tidak lengkap atau dengan infeksi HIV dieksklusi. Digunakan metode Spiegelhalter Knill-Jones untuk penyusunan skor kematian. Prediktor kematian dengan likelihood ratio (LHR) ≤0,5 atau ≥2 dimasukkan dalam sistem skor. Cut off point dari skor total ditentukan dengan kurva receiver operating characteristic (ROC).
Hasil. Di antara 225 anak yang memenuhi kriteria, 42 (18,7%) meninggal. Prediktor kematian yang memenuhi kriteria LHR adalah usia <6 bulan (LHR 2,05), takikardia (LHR 2,11), saturasi oksigen (SpO2) <92% (LHR 2,54), anemia (LHR 0,38) dan leukositosis (LHR 2,04). Skor prediksi kematian terdiri atas usia (skor=5 bila usia <6 bulan dan 0 bila >6 bulan); frekuensi nadi skor=6 bila takikardia dan -8 bila normal); saturasi oksigen (skor=3 bila SpO2 <92% dan 0 bila SpO2 >92%); hemoglobin (skor=4 bila anemia dan -6 bila normal), leukosit (skor=3 bila leukosit dan 0 bila normal). Total skor >3 Mempunyai sensitivitas dan spesifitas terbaik, yaitu 85,7% dan 72,1%.
Kesimpulan. Skor prediksi kematian pneumonia >3 dapat digunakan untuk memprediksi kematian pada anak dengan pneumonia.
Kata Kunci
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DOI: http://dx.doi.org/10.14238/sp18.3.2016.214-9
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