The Predictors of Mortality among Critically Ill Patients in Emergency Department, dr. Cipto Mangunkusumo Hospital
| Autor: | Claudia Lunaesti, Cindy Rahardja, Riyadh Firdaus, Andi A. Wijaya |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Journal Kedokteran Indonesia, Vol 2, Iss 3 (2014) |
| ISSN: | 2338-6037 2338-1426 |
| Popis: | Identifying the severity of patient’s condition is very important to be done in emergency department. The severity can be predicted by assessing vital signs of patients. Factors and scoring system in predicting mortality of critically ill patients in Indonesia remain unclear. We aimed to evaluate vital signs as predictors of mortality and determine whether Modified Early Warning Score(MEWS) can be used to predict mortality among Indonesian patients. We conducted a retrospective study of all patients admitted to the dr. Cipto Mangunkusumo Hospital’s emergency department (ED) from January-December 2011. Physiological parameters including consciousness, heart rate, respiratory rate, and blood pressure were obtained from medical records. MEWS were calculated from the data and non-parametric test was performed to identify predictors of 30-days mortality. Total of 579 patients were registered. The most common indication at admission was decrease in level of consciousness. Abnormal vital signs were associated with the increased odds of death. Patientswith bradypnea were the most likely to die compared to the other factors (OR 48.405; 95%CI 6.28373.12). The odds of death for in patient increased significantly as the MEWS increased >4 (OR 3.815; 95% CI 2.70-5.40). Decrease in level of consciousness, abnormal heart rate, abnormal respiratoryrate, and MEWS >4 increase the odds of death among critically ill patients in EDKeywords: predictors, death, critically ill patients, emergency department, MEWSAbstrakIdentifikasi severitas kondisi pasien sangat penting dilakukan di Instalasi Gawat Darurat (IGD). Tingkat severitas dapat diprediksi dengan menilai tanda vital pasien. Faktor dan sistem skoring prediktor mortalitas pasien kritis di Indonesia belum jelas. Penelitian ini bertujuan mengevaluasi tanda vital sebagai predictor mortalitas dan menentukan apakah skoring Modified Early Warning Score (MEWS) dapat digunakan untuk memprediksi mortalitas pasien di Indonesia.Penelitian dilakukan retrospektif dengan subjek semua pasien yang dirawat di IGD RS dr. Cipto Mangunkusumo (RSCM) pada 1 Januari-31 Desember 2011. Tingkat kesadaran, frekuensi nadi, frekuensi napas, dan tekanan darah didapatkan dari rekam medis. MEWS dihitung dan tes nonparametrik dilakukan untuk mengidentifikasi prediktor kematian 30 hari. Sebanyak 579 pasien menjadi subjek. Indikasi rawat inap tersering adalah penurunan kesadaran.Tanda vital abnormal diasosiasikan dengan peningkatan angka kematian. Bradipnea menjadi prediktor kematian utama dibanding faktor yang lain (OR 48.405; 95%CI 6.28-373.12). Angka kematian pasien rawat inap meningkat bila nilai MEWS >4 (OR 3.815; 95% CI 2.70-5.40). Penurunan kesadaran, frekuensinadi dan napas abnormal, dan MEWS >4 meningkatkan angka kematian pasien kritis di IGD.Kata kunci: prediktor, kematian, pasien kritis, gawat darurat, MEWS |
| Databáze: | OpenAIRE |
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