Performa Rapid Emergency Medicine Score dalam Memprediksi Outcome Pasien Trauma Kepala di Instalasi Gawat Darurat
DOI:
https://doi.org/10.21776/ub.jkb.2019.030.04.13Keywords:
IGD, outcome, REMS, trauma kepalaAbstract
Rapid Emergency Medicine Score (REMS) merupakan suatu sistem skor yang telah digunakan secara luas di berbagai negara untuk memprediksi mortalitas pasien non bedah maupun trauma di Instalasi Gawat Darurat (IGD), tetapi belum diuji pada populasi yang spesifik pada trauma kepala. Tujuan penelitian ini untuk menilai performa REMS dalam memprediksi outcome pasien trauma kepala di IGD. Penelitian ini menggunakan desain observasi analitik dengan pendekatan retrospektif. Sampel menggunakan data rekam medis pasien dengan trauma kepala sedang-berat disesuaikan dengan kriteria inklusi dan eksklusi dan digunakan teknik purposive sampling yaitu sebanyak 181 responden. Analisis bivariat yang dilakukan pada penelitian ini menggunakan uji Somers'd, sedangkan analisis multivariat menggunakan regresi logistik ordinal. Selanjutnya, kemampuan untuk memprediksi outcome dinilai menggunakan analisis the area under the receiver operating characteristic (AUROC). Hasil uji bivariat menunjukkan bahwa nilai somers'd REMS sebesar 0,310 dengan p value <0,001 dan arah hubungan positif dengan outcome pasien trauma kepala. Hasil regresi logistik ordinal menunjukkan parameter Glasgow Coma Scale (GCS) memperoleh Odds Ratio sebesar 0,7, artinya skor GCS yang rendah memiliki risiko memperoleh outcome death sebesar 0,7 kali lebih besar dibandingkan memperoleh outcome moderate disability, severe disability, persisten vegetatif state. Nilai Area Under Curve (AUC) REMS pada cut of point >5 dengan sensitivitas 61,4 dan spesifisitas 77,8 adalah 0,753 (95% CI; 0,683-0,814. REMS menunjukkan performa yang baik dalam memprediksi outcome pasien trauma kepala.
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