Electronic Theses and Dissertation

Latar belakang. angka mortalitas meningoensefalitis tuberkulosis masih tinggi. prognosis meningoensefalitis tuberkulosis sangat bergantung pada waktu diagnosis ditegakkan, respon terapi, gambaran klinis serta komplikasi yang terjadi. tujuan. mengetahui faktor risiko yang paling memengaruhi mortalitas meningoensefalitis tuberkulosis pada anak di rsud dr. zainoel abidin banda aceh. metode. penelitian ini merupakan studi kohort retrospektif terhadap anak yang terdiagnosis meningoensefalitis tuberkulosis yang dirawat di rsud dr. zainoel abidin selama periode januari 2023 – desember 2024. data dikumpulkan dari rekam medis 50 anak yang memenuhi kriteria penelitian. analisis data dilakukan menggunakan uji chi-square dan regresi logistik. hasil. total dari 50 subjek, 60% anak laki-laki, usia 12 bulan sampai 59 bulan (46%), dengan status gizi baik (40%). angka mortalitas mencapai 44%, dengan gcs ≤12 (74%), keadaan hiponatremia (52%), status epileptikus (62%), hidrosefalus (66%), dengan tindakan vp shunt (85%), tidak vaksin bcg (72%), dan riwayat kontak tb (48%). hasil uji bivariat terhadap luaran meningoensefalitis tuberkulosis didapatkan hasil berhubungan yaitu, gcs ≤12 (p=0,036), hidrosefalus (p=0,017), dan riwayat vaksinasi bcg (p=0,020). pada uji multivariat didapatkan faktor risiko paling memengaruhi luaran meningoensefalitis tuberkulosis adalah penurunan kesadaran gcs ≤12 dengan or 11,269 (p=0,011). kesimpulan. penurunan kesadaran, hidrosefalus dan riwayat vaksinasi bcg berhubungan dengan mortalitas pada anak dengan meningoensefalitis tuberkulosis. nilai gcs ≤12 merupakan faktor risiko paling memengaruhi dan vaksinasi bcg sebagai faktor risiko protektif. kata kunci: meningoensefalitis tuberkulosis, faktor risiko, mortalitas

Background. The mortality rate of tuberculous meningoencephalitis remains high. The prognosis of tuberculous meningoencephalitis depends greatly on the timing of diagnosis, therapeutic response, clinical presentation, and resulting complications. Objective. To identify the most significant risk factors associated with mortality in children diagnosed with tuberculous meningoencephalitis at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods. This was a retrospective cohort study involving pediatric patients diagnosed with tuberculous meningoencephalitis who were hospitalized at Dr. Zainoel Abidin General Hospital from January 2023 to December 2024. Data were collected from the medical records of 50 children who met the study criteria. Statistical analysis was performed using chi-square tests and logistic regression. Results. Of the 50 subjects, 60% were male, 46% were aged between 12 and 59 months, and 40% had good nutritional status. The overall mortality rate was 44%. Among the patients, 74% had a glasgow coma scale (GCS) score ≤12, 52% presented with hyponatremia, 62% had status epilepticus, 66% developed hydrocephalus, 85% with VP shunt, 72% had not received BCG vaccination, and 48% had a history of contact with tuberculosis. Bivariate analysis showed significant associations with mortality for GCS ≤12 (p = 0.036), hydrocephalus (p = 0.017), and BCG vaccination status (p = 0.020). Multivariate analysis revealed that decreased consciousness (GCS ≤12) was the strongest predictor of mortality, with an odds ratio (OR) of 11.269 (p = 0.011). Conclusion. Decreased consciousness, hydrocephalus, and BCG vaccination history are significantly associated with mortality in children with tuberculous meningoencephalitis. A GCS score ≤12 is the most influential risk factor, while BCG vaccination appears to be a protective factor. Keywords: tuberculous meningoencephalitis, risk factors, mortality