Hubungan skoring RIPASA dengan temuan histopatologi untuk menentukan diagnosis apendisitis akut pada pasien RSU Siloam periode Januari-Desember 2019 = The relationship between RIPASA score and histopathological findings in determining acute appendicitis diagnosis in RSU Siloam patients from January-December 2019

Viliecha, Clairine Chrestella (2020) Hubungan skoring RIPASA dengan temuan histopatologi untuk menentukan diagnosis apendisitis akut pada pasien RSU Siloam periode Januari-Desember 2019 = The relationship between RIPASA score and histopathological findings in determining acute appendicitis diagnosis in RSU Siloam patients from January-December 2019. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Latar Belakang: Apendisitis akut merupakan suatu kondisi yang sering terjadi dan membutuhkan tindakan operasi segera. Diagnosis dilakukan berdasarkan anamnesa, pemeriksaan fisik dan penunjang. Penegakkan diagnosis pasti, hanya dapat dilakukan setelah melihat temuan histopatologi jaringan apendiks setelah apendektomi. Sebelum apendektomi dilakukan, untuk membantu penegakkan diagnosis apendisitis akut terutama di Asia, skoring Raja Isteri Pengiran Anak Saleha Apendisitis (RIPASA) dapat digunakan, terutama pada tempat yang memiliki keterbatasan fasilitas. Tujuan Penelitian: Mengetahui apakah terdapat hubungan antara skoring RIPASA dengan temuan histopatologi jaringan apendiks untuk menentukan diagnosis pasien apendisitis akut. Metode Penelitian: Penelitian ini menggunakan studi analitik komparatif kategorik tidak berpasangan dengan desain studi cross-sectional. Sampel yang digunakan adalah 71 pasien apendisitis akut berusia di atas 15 tahun di RSU Siloam yang akan diambil dari rekam medis secara purposive-sampling. Temuan histopatologi pasien akan dikumpulkan dan dihubungkan dengan skoring RIPASA. Data yang memenuhi kriteria inklusi dan eksklusi akan dijadikan sampel, kemudian diolah menggunakan chi-square dan dianalisa menggunakan program SPSS 25.0. Hasil: Data yang telah dikumpulan sebanyak 71 sampel ditabulasi dalam tabel 3x3 dan diolah menggunakan pearson chi-square. Penelitian ini menunjukkan tidak adanya hubungan yang signifikan antara skoring RIPASA dengan temuan histopatologi untuk menentukan diagnosis apendisitis akut dengan nilai p-value sebesar 0,246. Nilai confidence interval 95% sebesar 0,241-0,463. Nilai sensitivitas, spesifisitas, dan cut-off diperoleh dari kurva ROC sebesar 92,3%, 13,8%, dan 7,5. Nilai duga positif dan nilai duga negatif diperoleh dari tabel 2x2 dan mendapatkan hasil 19,3% dan 88,9%. Simpulan: Tidak terdapat hubungan yang signifikan antara skoring RIPASA dengan temuan histopatologi untuk menentukan diagnosis apendisitis akut pada pasien RSU Siloam periode Januari–Desember 2019. Kata Kunci: Apendisitis Akut, Skoring RIPASA, Histopatologi Apendiks / Background: Acute appendicitis is a condition that often occurs and requires immediate surgery intervention. Diagnosis is based on history taking, physical and supporting examination. Definite diagnosis determination can only be done after appendectomy, by looking at the appendix tissue histopathological findings. Before appendectomy is performed, to help determining acute appendicitis diagnosis particularly in Asia, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score can be used, especially in places with limited facilities. Aim of Study: To know the relationship between RIPASA score and appendix tissue histopathological findings in determining acute appendicitis diagnosis. Methods: This study uses unpaired categorical comparative analytic study with cross-sectional study design. Sample used is 71 acute appendicitis patients aged over 15 years old at RSU Siloam which will be taken from medical record by using purposive-sampling method. Patient’s histopathological findings will be collected and linked to RIPASA score. Data that meets the inclusion and exclusion criteria will be the samples, then processed with chi square and will be analysed using SPSS 25.0 program. Result: 71 collected samples were tabulated in the 3x3 table and processed using pearson chi-square. This study shows that there is no significant relationship between RIPASA scoring with the histopathological findings in determining the acute appendicitis diagnosis with a p-value of 0.246. The 95% confidence interval is 0.241-0.463. Sensitivity, specificity, and cut-off value were obtained from the ROC curve of 92.3%, 13.8%, and 7.5. Positive predictive value and negative predictive value were obtained from the 2x2 table and the results obtained were 19.3% and 88.9%. Conclusion: There is no significant correlation between RIPASA score and appendix tissue histopathological findings in determining acute appendicitis diagnosis on RSU Siloam January-December 2019 patients. Keywords: Acute Appendicitis, RIPASA score, Appendix Histopathology

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