Electronic Theses and Dissertation

ABSTRAK

Latar Belakang: Kematian bayi masih menjadi permasalahan kesehatan global dan nasional. Berbagai upaya telah dilakukan, salah satunya dengan melakukan segera penilaian derajat keparahan penyakit neonatus saat dirawat dengan menggunakan sistem skoring dalam memprediksi morbiditas dan mortalitas neonatus. Beberapa sistem skoring telah banyak dikembangkan termasuk Clinical Risk Index for Babies-II (CRIB-II) dan Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II).
Tujuan : Untuk mengetahui perbandingan sistem skoring CRIB-II dan skor SNAPPE-II sebagai prediktor mortalitas neonatus.

Metode: Penelitian kohort prospektif ini dilakukan di Neonatal Intensive Care Unit (NICU) RSUD dr. Zainoel Abidin Banda Aceh sejak Desember 2022 hingga Maret 2023 dengan usia kehamilan ≤ 32 minggu menggunakan sistem penilaian CRIB-II dan SNAPPE-II untuk menilai mortalitas pada neonatus selama mendapat perawatan intensif dalam 24 jam pertama setelah lahir. Perbedaan masing-masing prediktor dianalisis menggunakan Received Operating Curved (ROC) dan uji Chi-Squared dengan tingkat kepercayaan 95% untuk menentukan sensitivitas, spesifisitas, nilai duga negatif, nilai duga positif, dan titik potong optimal dari masing-masing skor tersebut. .

Hasil: Selama periode penelitian, terdapat 37 bayi yang diikutkan dalam penelitian ini dengan luaran 24 subjek meninggal dan 13 subjek hidup. Sistem skor SNAPPE-II menunjukkan kemaknaan prediksi mortalitas yang lebih baik dibandingkan dengan CRIB-II dengan sensitivitas 70.8%, spesifisitas 84.6%, nilai duga positif 61.1%, nilai duga negatif 89.4% dan akurasi 75.6% dengan titik potong optimal SNAPPE-II dalam memprediksi mortalitas neonatus adalah 28.5 Sistem skor CRIB-II menunjukkan nilai sensitivitas 58.3%, spesifisitas 84.6%, nilai duga negatif 87.5%, nilai duga positif 52.3%, akurasi 67.5% dengan titik potong optimal adalah 3.5.

Kesimpulan: Sistem skoring SNAPPE-II lebih baik dibandingkan dengan skor CRIB-II sebagai prediktor mortalitas neonatus di NICU RSUD dr. Zainoel Abidin.

Kata Kunci: Mortalitas, neonatus, SNAPPE-II, CRIB-II, NICU

ABSTRACT Background: Infant mortality is still a global and national health problem. Various attemps have been made, one of which is by immediately assesing the severity of neonatal diseases while being treated using a scoring system to predict neonatal morbidity and mortality. Scoring systems include the Clinical Risk Index for Babies-II (CRIB-II) and the Score for Neonatal Acute Physiology with Perinatal Extension-II (SNAPPE-II). Objective: This study aims to comparison at the differences between CRIB-II and SNAPPE-II as a predictor of neonatal mortality in NICU RSUDZA Banda Aceh. Methods: Prospective cohort study was conducted at the Neonatal Intensive Care Unit (NICU) of RSUD dr. Zainoel Abidin Banda Aceh from December 2022 to March 2023 with the gestasional age ≤ 32 weeks using the CRIB-II and SNAPPE-II scoring systems were used to assess the mortality of research subjects while receiving intensive care within the first 24 hour after birth. Differences in the significance of each predictor were analyzed using the Received Operating Curved (ROC) and the Chi-Squared test with a 95% confidence level. Results: During the periode of study, 37 children were eligible in this study with a distribution of 24 died and 13 survived. The SNAPPE-II scoring system showed better mortality prediction significance compared to CRIB-II with a sensitivity of 70.8%, a specificity of 84.6%, a positive predictive value of 61.1%, a negative predictive value of 89.4% and an accuracy of 75.6%. The optimal cut off point for SNAPPE-II in predicting neonatal mortality was 28.5 (sensitivity 70.8%; specificity 84.5%). Conclusion: The SNAPPE-II scoring system has a good predictive ability for assessing the risk of neonatal mortality than the CRIB-II scoring system in the NICU of RSUD dr. Zainoel Abidin. Keywords: Mortality, neonates, SNAPPE-II, CRIB-II, NICU