Faktor Prediksi Perforasi Apendiks pada Penderita Apendisitis Akut Dewasa di RS Al-Ihsan Kabupaten Bandung Periode 2013–2014

Abstract

Morbiditas dan mortalitas apendisitis akut disebabkan oleh perkembangan apendisitis akut menjadi perforasi apendiks. Hal-hal yang menyebabkan kerentanan apendiks belum banyak diteliti dan belum diketahui penyebab pastinya. Tujuan penelitian ini adalah mengetahui faktor-faktor apa saja yang dapat memprediksi terjadinya perforasi apendiks. Penelitian dengan desain kasus kontrol menggunakan data sekunder berupa rekam medis penderita apendisitis akut dewasa di RS Al-Ihsan Kabupaten Bandung tahun 2013–2014 dengan jumlah kasus (perforasi apendiks) 36 kasus dan kontrol (nonperforasi) 93 kasus. Analisis data yang dilakukan meliputi deskriptif, chi-square, receiver operating characteristic, dan regresi logistik multivariat. Dua faktor prediksi yang bermakna sebagai faktor prediksi perforasi apendiks dalam analisis regresi logistik multivariat adalah suhu badan di atas 37,5°C dengan odds ratio (OR) 7,54 (IK 95%: 2,01–28,33), jumlah leukosit di atas 11.500/mm³ dengan OR 12,12 (IK 95%: 4,03–36,48). Perlu validasi pemeriksaan suhu badan di RS, penelitian lebih lanjut untuk mencari faktor prediksi lainnya, persiapan operasi segera untuk pencegahan komplikasi perforasi apendiks, dan pemberian informasi ke masyarakat bahwa sakit perut dapat bersifat gawat darurat.

PREDICTIVE FACTORS FOR PERFORATED APPENDIX IN ACUTE APPENDICITIS ADULT PATIENTS IN AL-IHSAN HOSPITAL BANDUNG REGENCY 2013–2014

Appendix perforation is the causation for acute appendicitis morbidity and mortality. Factors that may cause appendix vulnerability has not been extensively studied before and the main cause is still yet unknown. The goal of this study was to analyze what factors that could be used to predict appendix perforation. This study was a case control study using 2013–2014 medical records in Al-Ihsan Hospital Bandung Regency as data. Case group pooled from 36 perforated appendix adult (above 15 years old) patients, while control group pooled from 93 non perforated appendix adult patients. Data analysis conducted were descriptive, chi-square, receiver operating characteristic, and multivariate logistic regression. There were two prediction factors which significantly associated with perforated appendix. Those were body temperature above 37.5°C with odds ratio (OR) 7.54 (95% CI: 2.01–28.33), and leucocytes count above 11,500/mm³ with OR 12.12 (95% CI: 4.03–36.48). Further studies and body temperature validation on each hospital are needed to find other prediction factors, preparing pre operative equipment for immediate definite measure like surgery to prevent the complication of perforated appendix, and education to people that abdominal pain is not always causing by gastric problem and it might be a case of emergency.