Perbandingan antara skor apfel dan koivuranta sebagai sistem skor mual dan muntah pasca operasi dengan anestesi umum di Rumah Sakit Umum Siloam Lippo Karawaci

Ramadhanti, Mutiara (2020) Perbandingan antara skor apfel dan koivuranta sebagai sistem skor mual dan muntah pasca operasi dengan anestesi umum di Rumah Sakit Umum Siloam Lippo Karawaci. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Latar Belakang: Postoperative Nausea and Vomiting (PONV) atau mual dan muntah pasca operasi adalah efek samping yang umum terjadi pada 24-48 jam setelah menjalani operasi. Angka kejadian PONV terjadi 30% pada semua pasien pasca operasi dan hingga 80% pada pasien berisiko tinggi. Skor Apfel dan skor Koivuranta merupakan skor risiko sederhana yang telah digunakan untuk tujuan klinis sehari-hari dalam memprediksi kejadian PONV pada pasien. Namun, belum ada penelitian menunjukan skor mana yang lebih dapat memprediksi terjadinya PONV yang dilakukan di Rumah Sakit Umum Siloam Karawaci sehingga dapat ditentukan pencegahan serta penanganan yang tepat dalam menyikapi terjadinya PONV . Tujuan Penelitian: Mengetahui perbandingan antara skor Apfel dan skor Koivuranta terhadap mual dan muntah pasca operasi di Rumah Sakit Umum Siloam Karawaci. Metode Penelitian: Penelitian menggunakan studi analitik deskriptif dengan desain studi potong lintang. Sampel penelitian berjumlah 75 subjek yang merupakan pasien pasca operasi di Rumah Sakit Umum Siloam Lippo Karawaci. Hasil dan Pembahasan: Nilai diagnostik, sensitivitas dan spesifisitas dari skor Apfel adalah 57.3%, 82.9%, dan 26.5% serta nilai prediktif positif dan nilai prediktif negatif sebesar 57.6% dan 56.3%. Skor Koivuranta memiliki nilai diagnostik, sensitivitas dan spesifisitas 41.32%, 26.8%, dan 58.8% serta nilai prediktif positif dan nilai prediksi negatif sebesar 44% dan 40%. Skor Apfel memiliki nilai sensitivitas lebih tinggi dan skor Koivuranta memiliki spesifisitas lebih tinggi. Namun, dari hasil nilai diagnostik, nilai prediktif positif, dan nilai prediktif negatif, skor Apfel memiliki persentase yang lebih tinggi dibandingkan skor Koivuranta. Kesimpulan : Sistem skor faktor risiko PONV skor Apfel memiliki persentase nilai yang lebih tinggi dan memiliki variabel penentu skor yang lebih sederhana dibanding skor Koivuranta dalam mengidentifikasi pasien dengan risiko tinggi untuk PONV. / Background: Postoperative Nausea and Vomiting (PONV) are common side effects that occur 24-48 hours after surgery. The incidence of PONV is 30% in all post- surgical patients and up to 80% in high-risk patients. Apfel and Koivuranta scores are simplified risk scores used for daily clinical purposes in predicting the incidence of postoperative nausea and vomiting in patients. However, no studies are showing which score can better predict the occurrence of PONV conducted at Rumah Sakit Umum Siloam Karawaci so that, it can determine the prevention and appropriate treatment in response to the occurring of PONV. Aim: To compare the score of Apfel and Koivuranta as scoring system of PONV at Rumah Sakit Umum Siloam Karawaci. Methods: This study method uses a cross-sectional analytic study design. The sample consisted of 75 subjects who were postoperative patients in Rumah Sakit Umum Siloam Lippo Karawaci. Results: Diagnostic values, sensitivity, and specificity of the Apfel score were 57.3%, 82.9%, and 26.5%, as well as positive predictive values and negative predictive values of 57.6% and 56.3%. Koivuranta scores have diagnostic, sensitivity, and specificity values of 41.32%, 26.8%, and 58.8%, as well as positive predictive values and negative predictive values of 44% and 40%. Apfel scores have a higher sensitivity value, and Koivuranta scores have a higher specificity. However, from the results of diagnostic values, positive predictive values, and negative predictive values, the Apfel score has a higher percentage than the Koivuranta score. Conclusion: The PONV risk factor score system Apfel score had the highest value and simpler scoring variable than the Koivuranta score in the assessment of high- risk patients for PONV.

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