Performa Rapid Emergency Medicine Score dalam Memprediksi Outcome Pasien Trauma Kepala di Instalasi Gawat Darurat

Authors

DOI:

https://doi.org/10.21776/ub.jkb.2019.030.04.13

Keywords:

IGD, outcome, REMS, trauma kepala

Abstract

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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References

Weber KT, Guimarães VA, Pontes-Neto OM, Leite JP, Takayanagui OM, and Santos-Pontelli TEG. Preditores De Qualidade De Vida Após Trauma CrâNio-Encefálico Moderado A Grave. Arquivos de Neuro-Psiquiatria. 2016; 74(5): 409-415.

Venturini S, Still MEH, Vycheth I, Nang S, Vuthy D, and Park KB. The National Motorcycle Helmet Law at 2 Years: Review of Its Impact on the Epidemiology of Traumatic Brain Injury in a Major Government Hospital in Cambodia. World Neurosurgery. 2019; 125: 320-326.

Miller RT, Nazir N, McDonald T, and Cannon CM. The Modified Rapid Emergency Medicine Score: A Novel Trauma Triage Tool To Predict In-Hospital Mortality. Injury. 2017; 48(9): 1870-1877.

Scheetz LJ, Horst MA, and Arbour RB. Early Neurological Deterioration in Older Adults with Traumatic Brain Injury. International Emergency Nursing. 2018; 37: 29-34.

Najafi Z, Zakeri H, and Mirhaghi A. The Accuracy of Acuity Scoring Tools to Predict 24-H Mortality in Traumatic Brain Injury Patients: A Guide to Triage Criteria. International Emergency Nursing. 2018; 36: 27-33.

Gök RGY, Gök A, and Bulut M. Assessing Prognosis with Modified Early Warning Score, Rapid Emergency Medicine Score and Worthing Physiological Scoring System in Patients Admitted to Intensive Care Unit from Emergency Department. International Emergency Nursing. 2019; 43: 9-14.

Park HO, Kim JW, Kim SH, et al. Usability Verification of the Emergency Trauma Score (EMTRAS) and Rapid Emergency Medicine Score (REMS) in Patients with Trauma: A Retrospective Cohort Study. Medicine. 2017; 96(44): 1-5.

Imhoff BF, Thompson NJ, Hastings MA, Nazir N, Moncure M, and Cannon CM. Rapid Emergency Medicine Score (REMS) in the Trauma Population: A Retrospective Study. BMJ Open. 2014; 4(5): 1-7.

Nakhjavan-shahraki B, Baikpour M, Yousefifard M, et al. Rapid Acute Physiology Score Versus Rapid Emergency Medicine Score in Trauma Outcome Prediction; A Comparative Study. Emergency. 2017; 5(1): 165-172.

Olsson T, Terent A, and Lind L. Rapid Emergency Medicine Score Can Predict Long-Term Mortality in Nonsurgical Emergency Department Patients. Academic Emergency Medicine. 2004; 11(10): 1008-1013.

Hartoyo M, Raharjo SS, and Budiyati. Predictor ' S Factors of Mortality of Patients Suffering from Severe Head Injury in Emergency Department at General Hospital Tugurejo Semarang. Jurnal Riset Kesehatan. 2012; 1(3): 175-182.

Oliveira RA, Araújo S, and Falcão AL. Glasgow Outcome Scale at Hospital Discharge as a Prognostic Index in Patients with Severe Traumatic Brain Injury. Arquivos de Neuro-Psiquiatria. 2012; 70(8): 604-608.

Marcolini EG, Albrecht JS, Sethuraman KN, and Napolitano LM. Gender Disparities in Trauma Care: How Sex Determines Treatment, Behavior, and Outcome. Anesthesiology Clinics. 2019; 37(1): 107-117.

Lisnawati, Kwandou L, Akbar M, Muis A, Kaelan C, and Patellongi I. Hubungan Skor Cognitive Test for Delirium (CTD) dengan Luaran Berdasarkan Glasgow Outcome Scale (GOS) pada Penderita Cedera Kepala Tertutup Ringan-Sedang. Jurnal Sains & Teknologi Kesehatan. 2012; 2(2): 163-170.

Peeters W, van den Brande R, Polinder S, et al. Epidemiology of Traumatic Brain Injury in Europe. Acta Neurochirurgica. 2015; 157(10): 1683-1696.

Krisandi E, Utomo W, dan Indriati G. Gambaran Status Kognitif pada Pasien Cedera Kepala yang Telah Di Izinkan Pulang Di RSUD Arifin Achmad Pekanbaru. [Repository]. Universitas Riau, Riau. 2013.

Alter SM, Infinger A, Swanson D, and Studnek JR. Evaluating Clinical Care in the Prehospital Setting: Is Rapid Emergency Medicine Score the Missing Metric of EMS? The American Journal of Emergency Medicine. 2017; 35(2): 218-221.

Lee YS, Choi JW, Park YH, et al. Evaluation of the Efficacy of the National Early Warning Score in Predicting in-Hospital Mortality Via the Risk Stratification. Journal of Critical Care. 2018; 47: 222-226.

Suwaryo PAW, Wihastuti TA, dan Fathoni M. Analisis Faktor-faktor yang Berhubungan dengan Outcome Pasien Cedera Kepala di IGD RSUD Prof. Dr. Margono Soekardjo Purwoerto. Jurnal Ilmiah Kesehatan Keperawatan. 2016; 12(3): 154-164.

Khan KA, Choudhary M, Sinha VD, Gora N, and Bairwa M. Predictors of Outcome after Traumatic Brain Injuries: Experience of a Tertiary Health Care Institution in Northwest India. World Neurosurgery. 2019; 126: 699-705.

Seak CJ, Yen DHT, Ng CJ, et al. Rapid Emergency Medicine Score: A Novel Prognostic Tool for Predicting the Outcomes of Adult Patients with Hepatic Portal Venous Gas in the Emergency Department. PLoS One. 2017; 12(9): 1-9.

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Published

2019-08-30

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Section

Research Article