Pengaruh Hipomagnesemia Terhadap Mortalitas Pasien Anak di Ruang Rawat Intensif

Abstract

Latar belakang. Magnesium merupakan kation intraselular kedua terbanyak setelah kalium. Pasien dengan penyakit kritis yang dirawat di ruang rawat intensif memiliki risiko tinggi terjadinya hipomagnesemia. Pasien dengan hipomagnesemia memiliki mortalitas yang tinggi. Tujuan. Melakukan analisis pengaruh hipomagnesemia terhadap mortalitas pada pasien anak di ruang rawat intensif. Metode.Penelitian bersifat kohort prospektif dilakukan pada bulan Mei hingga Juli 2016 di PICU dan HCU RS Dr. Moewardi Surakarta. Subjek berjumlah 40 anak diambil secara konsekutif. Analisis statistik dilakukan dengan program SPSS 22.0 menggunakan uji chi square atau Fisher bila syarat uji chi square tidak terpenuhi, uji t independen bila sebaran data normal, atau uji Mann Whitney bila sebaran data tidak normal. Pengaruh faktor risiko dan mortalitas dianalisis dengan logistik regresi. Hasil. Di antara 40 anak terdapat 21 orang laki-laki, 26 dengan penyakit non bedah dan 18 anak gizi baik. Kejadian hipomagnesemia terdapat pada 5 dan 1 anak di antaranya meninggal. Hipomagnesemia tidak berhubungan dengan mortalitas (p=1,000; OR 1,00; IK95% 0,096-10.408). Faktor risiko yang berhubungan dengan mortalitas adalah jenis penyakit non bedah. Jenis kelamin, usia, status nutrisi dan jenis penyakit tidak berhubungan dengan mortalitas. Kesimpulan. Tidak terdapat pengaruh hipomagnesemia terhadap mortalitas. Faktor risiko yang berhubungan dengan mortalitas adalah jenis penyakit non bedah. Sari Pediatri 2016;18(4):308-13 Kata kunci: hipomagnesemia,mortalitas, PRISM III The Effect of Hypomagnesemia to Mortality of Children in Intensive Care UnitResa Gratya, Sri Martuti, Harsono Salimo Background. Magnesium is the second largest intracellular cation after potassium. Patients with critical illness in intensive care unit have a high risk of hypomagnesemia. Patient with hypomagnesemia has high incidence in mortality. Objective. To analyze the effects between hypomagnesemia and mortality as well as the mortality risk factors in critically ill children. Methods. Prospective cohort study was conducted between May and July 2016 at PICU and HCU Moewardi Hospital. Fourty children were enrolled consecutively. Data were analyzed with SPSS 22.0 statistical analizes chi square, logistic regression. Results. Of the 40 children, 21 were girls, 26 children with non-surgical type of disease and 18 chilren were malnourished. Hypomagnesemia presented in 5 children and 1 of them passed away. The risk factors associated with mortality were: PRISM III score ≥8, non surgical cases. Hypomagnesemia was not associated with mortality(p = 1.000; OR 1.00; 95% CI 0.096 to 10.408). Gender, age, nutritional status and type of disease were not associated with mortality. Conclusion. Hypomagnesemia were not associated with mortality in critically ill children. Hypomagnesemia occurred in 12.5% of children and PRISM III scores ≥8 was a risk factor for mortality. Sari Pediatri 2016;18(4):308-13

Children mortality in Pediatric Intensive Care Unit (PICU): An Overview

“…Patients with non-surgical diseases experienced higher mortality than the types of surgical diseases. The results of this study are supported by previous studies conducted 9 which states that there was a significant correlation between types of disease, with the incidence of mortality, patients with nonsurgical diseases have seven times higher risk of death. After that, the severity of the disease greatly affects death in patients and had significant correlation with mortality of children 3 .…”

“…Objective criteria in this study, including the age categories of infants, toddlers, preschools, schools, and teen, variable type of disease including surgical and non-surgical, previous studies have shown causes of death that occur in PICU differ from surgical or nonsurgical types 9 , variable final diagnosis based on observations that have been obtained by researchers, the disease most suffered by PICU patients is in the case of sepsis. In this case the neurological status can be determined by using the Glasgow Coma Scale (GCS) or Full Outline of Unresponsiveness (FOUR) score which is a scale used to determine the patient's neurological status when first treated in the PICU room which is listed in the medical record with objective criteria include severe neurological status, if the GCS score is ≤ 8 and the FOUR score is ≤ 7, moderate neurological status, if the GCS score is 9-13 and the FOUR score is 8-14, mild neurological status, if the GCS score is 14-15 10 and FOUR Score is 15-16 11 .…”