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Faktor-faktor yang Mempengaruhi Kejadian Kardiovaskular Mayor (KKM) pada Pasien Infark Miokard Akut (IMA)

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DAFTAR

RIWAYAT

HIDUP

Nama

: Suyata Adelina Tanjung

Tempat/Tanggal Lahir

: Balige, 22 Oktober 1995

Jenis Kelamin

: Perempuan

Agama

: Kristen Protestan

Alamat

: Jl. Universitas No. 34 Medan

Nomor HP

: 085372422720

Email

: suyatat638@gmail.com

Riwayat Pendidikan

Tahun 2001-2007

: SDK San Francesco Balige

Tahun 2007-2010

: SMP Swasta Budhi Dharma Balige

Tahun 2010-2013

: SMA Negeri 2 Balige, Asrama Yayasan

Soposurung, Balige

Tahun 2013 s.d sekarang

: Kuliah Pendidikan Dokter Fakultas

Kedokteran Universitas Sumatera Utara

Riwayat Organisasi

Tahun 2012-2013

: Bendahara I Senat Siswa/i Asrama

Yayasan Soposurung Balige

Tahun 2013-sekarang

: Anggota PARYASOP MEDAN

Tahun 2014-sekarang

: Anggota KMK USU UP FK

(2)
(3)
(4)

TABEL PENGOLAHAN DATA

1. Analisis Univariat a. Usia

Usia

Frequency Percent Valid Percent

Cumulative

Percent

Valid 21-30 1 .9 .9 .9

31-40 1 .9 .9 1.7

42-50 22 19.0 19.0 20.7

51-60 48 41.4 41.4 62.1

61-70 33 28.4 28.4 90.5

71-80 10 8.6 8.6 99.1

91-100 1 .9 .9 100.0

Total 116 100.0 100.0

b. Jenis Kelamin

Jenis Kelamin

Frequency Percent Valid Percent

Cumulative

Percent

Valid Laki-laki 91 78.4 78.4 78.4

Perempuan 25 21.6 21.6 100.0

Total 116 100.0 100.0

Umur * Sex Crosstabulation

Sex

Total Laki-laki Perempuan

Umur <40 tahun Count 2 0 2

% of Total 1.7% .0% 1.7%

40-49 tahun Count 18 2 20

% of Total 15.5% 1.7% 17.2%

50-59 tahun Count 38 11 49

% of Total 32.8% 9.5% 42.2%

60-69 tahun Count 24 6 30

(5)

>=70 tahun Count 9 6 15

% of Total 7.8% 5.2% 12.9%

Total Count 91 25 116

% of Total 78.4% 21.6% 100.0%

c. Jenis KKM

CHF

Frequency Percent Valid Percent

Cumulative

Percent

Valid CHF 43 37.1 37.1 37.1

Tidak 73 62.9 62.9 100.0

Total 116 100.0 100.0

Aritmia

Frequency Percent Valid Percent

Cumulative

Percent

Valid Aritmia 16 13.8 13.8 13.8

Tidak 100 86.2 86.2 100.0

Total 116 100.0 100.0

Syok Kardiogenik

Frequency Percent Valid Percent

Cumulative

Percent

Valid SK 15 12.9 12.9 12.9

Tidak 101 87.1 87.1 100.0

Total 116 100.0 100.0

Kematian

Frequency Percent Valid Percent

Cumulative

Percent

Valid 2 101 87.1 87.1 87.1

1 15 12.9 12.9 100.0

(6)

JenisKKM

Frequency Percent Valid Percent

Cumulative

Percent

Valid 1.00 33 28.4 56.9 56.9

2.00 5 4.3 8.6 65.5

2,3,4 3 2.6 5.2 70.7

3,4 5 4.3 8.6 79.3

1,3,4 2 1.7 3.4 82.8

1,4 1 .9 1.7 84.5

1,3 1 .9 1.7 86.2

1,2,3,4 3 2.6 5.2 91.4

2,4 1 .9 1.7 93.1

2,3 1 .9 1.7 94.8

1,2 3 2.6 5.2 100.0

Total 58 50.0 100.0

Missing System 58 50.0

Total 116 100.0

2. Analisis Bivariat a. Usia*KKM

USIA * KKM Crosstabulation

KKM

Total KKM Tidak

USIA >65 tahun Count 15 10 25

% of Total 12.9% 8.6% 21.6%

<=65 tahun Count 43 48 91

% of Total 37.1% 41.4% 78.4%

Total Count 58 58 116

(7)

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 1.275a 1 .259

Continuity Correctionb .816 1 .366

Likelihood Ratio 1.282 1 .258

Fisher's Exact Test .367 .183

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 12.50.

b. Computed only for a 2x2 table

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 1.674

ln(Estimate) .515

Std. Error of ln(Estimate) .459

Asymp. Sig. (2-sided) .262

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound .681

Upper Bound 4.118

ln(Common Odds Ratio) Lower Bound -.384

Upper Bound 1.415

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

b. Jenis Kelamin*KKM

Jenis Kelamin * KKM Crosstabulation

KKM

Total KKM Tidak

Jenis Kelamin Laki-laki Count 45 46 91

% of Total 38.8% 39.7% 78.4%

Perempuan Count 13 12 25

% of Total 11.2% 10.3% 21.6%

Total Count 58 58 116

(8)

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square .051a 1 .821

Continuity Correctionb .000 1 1.000

Likelihood Ratio .051 1 .821

Fisher's Exact Test 1.000 .500

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 12.50.

b. Computed only for a 2x2 table

Mantel-Haenszel Common Odds Ratio Estimate

Estimate .903

ln(Estimate) -.102

Std. Error of ln(Estimate) .452

Asymp. Sig. (2-sided) .821

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound .372

Upper Bound 2.190

ln(Common Odds Ratio) Lower Bound -.988

Upper Bound .784

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

c. Heart Rate*KKM

Heart Rate * KKM Crosstabulation

KKM

Total KKM Tidak

Heart Rate >100 Count 15 3 18

% of Total 12.9% 2.6% 15.5%

<=100 Count 43 55 98

% of Total 37.1% 47.4% 84.5%

Total Count 58 58 116

(9)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 6.395

ln(Estimate) 1.856

Std. Error of ln(Estimate) .664

Asymp. Sig. (2-sided) .005

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound 1.739

Upper Bound 23.518

ln(Common Odds Ratio) Lower Bound .553

Upper Bound 3.158

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

d. TDs*KKM

Tekanan Darah Sistolik * KKM Crosstabulation

KKM

Total KKM Tidak

Tekanan Darah Sistolik <100 mmHg Count 12 4 16

% of Total 10.3% 3.4% 13.8%

>=100 mmHg Count 46 54 100

% of Total 39.7% 46.6% 86.2%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 4.640a 1 .031

Continuity Correctionb 3.553 1 .059

Likelihood Ratio 4.827 1 .028

Fisher's Exact Test .057 .028

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 8.00.

(10)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 3.522

ln(Estimate) 1.259

Std. Error of ln(Estimate) .611

Asymp. Sig. (2-sided) .039

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound 1.063

Upper Bound 11.669

ln(Common Odds Ratio) Lower Bound .061

Upper Bound 2.457

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

e. Hemoglobin*KKM

Hemoglobin * KKM Crosstabulation

KKM

Total KKM Tidak

Hemoglobin 1.00 Count 25 8 33

% of Total 21.6% 6.9% 28.4%

2.00 Count 33 50 83

% of Total 28.4% 43.1% 71.6%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 12.240a 1 .000

Continuity Correctionb 10.842 1 .001

Likelihood Ratio 12.700 1 .000

Fisher's Exact Test .001 .000

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 16.50.

(11)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 4.735

ln(Estimate) 1.555

Std. Error of ln(Estimate) .464

Asymp. Sig. (2-sided) .001

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound 1.907

Upper Bound 11.756

ln(Common Odds Ratio) Lower Bound .646

Upper Bound 2.464

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

f. Leukosit*KKM

Leukosit * KKM Crosstabulation

KKM

Total KKM Tidak

Leukosit >10000/mm3 Count 49 39 88

% of Total 42.2% 33.6% 75.9%

<=10000/mm3 Count 9 19 28

% of Total 7.8% 16.4% 24.1%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 4.708a 1 .030

Continuity Correctionb 3.813 1 .051

Likelihood Ratio 4.790 1 .029

Fisher's Exact Test .050 .025

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 14.00.

(12)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 2.652

ln(Estimate) .975

Std. Error of ln(Estimate) .458

Asymp. Sig. (2-sided) .033

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound 1.081

Upper Bound 6.509

ln(Common Odds Ratio) Lower Bound .078

Upper Bound 1.873

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

g. Natrium*KKM

Natrium Darah * KKM Crosstabulation

KKM

Total KKM Tidak

Natrium Darah 1.00 Count 33 19 52

% of Total 28.4% 16.4% 44.8%

2.00 Count 25 39 64

% of Total 21.6% 33.6% 55.2%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 6.832a 1 .009

Continuity Correctionb 5.891 1 .015

Likelihood Ratio 6.904 1 .009

Fisher's Exact Test .015 .007

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 26.00.

(13)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 2.709

ln(Estimate) .997

Std. Error of ln(Estimate) .385

Asymp. Sig. (2-sided) .010

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound 1.273

Upper Bound 5.767

ln(Common Odds Ratio) Lower Bound .241

Upper Bound 1.752

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

h. LDL*KKM

LDLdarah * KKM Crosstabulation

KKM

Total KKM Tidak

LDLdarah >=160 mg/dl Count 14 8 22

% of Total 12.1% 6.9% 19.0%

<160 mg/dl Count 44 50 94

% of Total 37.9% 43.1% 81.0%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 2.019a 1 .155

Continuity Correctionb 1.402 1 .236

Likelihood Ratio 2.041 1 .153

Fisher's Exact Test .236 .118

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 11.00.

(14)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 1.989

ln(Estimate) .687

Std. Error of ln(Estimate) .489

Asymp. Sig. (2-sided) .160

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound .763

Upper Bound 5.186

ln(Common Odds Ratio) Lower Bound -.271

Upper Bound 1.646

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

i. Riwayat DM*KKM

Riwayat DM * KKM Crosstabulation

KKM

Total KKM Tidak

Riwayat DM Diabetes Melitus Count 21 14 35

% of Total 18.1% 12.1% 30.2%

Tidak Diabetes Melitus Count 37 44 81

% of Total 31.9% 37.9% 69.8%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square 2.005a 1 .157

Continuity Correctionb 1.473 1 .225

Likelihood Ratio 2.015 1 .156

Fisher's Exact Test .225 .112

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 17.50.

(15)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 1.784

ln(Estimate) .579

Std. Error of ln(Estimate) .411

Asymp. Sig. (2-sided) .159

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound .797

Upper Bound 3.991

ln(Common Odds Ratio) Lower Bound -.227

Upper Bound 1.384

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

j. Riw. Merokok*KKM

Riwayat Merokok * KKM Crosstabulation

KKM

Total KKM Tidak

Riwayat Merokok Merokok Count 39 39 78

% of Total 33.6% 33.6% 67.2%

Tidak Merokok Count 19 19 38

% of Total 16.4% 16.4% 32.8%

Total Count 58 58 116

% of Total 50.0% 50.0% 100.0%

Chi-Square Tests

Value df

Asymp. Sig.

(2-sided)

Exact Sig.

(2-sided)

Exact Sig.

(1-sided)

Pearson Chi-Square .000a 1 1.000

Continuity Correctionb .000 1 1.000

Likelihood Ratio .000 1 1.000

Fisher's Exact Test 1.000 .578

N of Valid Cases 116

a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 19.00.

(16)

Mantel-Haenszel Common Odds Ratio Estimate

Estimate 1.000

ln(Estimate) .000

Std. Error of ln(Estimate) .396

Asymp. Sig. (2-sided) 1.000

Asymp. 95% Confidence

Interval

Common Odds Ratio Lower Bound .460

Upper Bound 2.172

ln(Common Odds Ratio) Lower Bound -.775

Upper Bound .775

The Mantel-Haenszel common odds ratio estimate is asymptotically normally distributed under the common

odds ratio of 1.000 assumption. So is the natural log of the estimate.

3. Analisi Multivariat

Case Processing Summary

Unweighted Casesa N Percent

Selected Cases Included in Analysis 116 100.0

Missing Cases 0 .0

Total 116 100.0

Unselected Cases 0 .0

Total 116 100.0

a. If weight is in effect, see classification table for the total number of cases.

Dependent Variable Encoding

Original Value Internal Value

Tidak KKM 0

KKM 1

Categorical Variables Codings

Frequency

Parameter coding

(1)

HR <=100 x/menit 98 .000

(17)

Block 0: Beginning Block

Iteration Historya,b,c

Iteration -2 Log likelihood

Coefficients

Constant

Step 0 1 160.810 .000

a. Constant is included in the model.

b. Initial -2 Log Likelihood: 160.810

c. Estimation terminated at iteration number 1 because

parameter estimates changed by less than .001.

Classification Tablea,b

Observed

Predicted

KKM

Percentage Correct Tidak KKM KKM

Step 0 KKM Tidak KKM 0 58 .0

KKM 0 58 100.0

Overall Percentage 50.0

a. Constant is included in the model.

b. The cut value is .500

Variables in the Equation

B S.E. Wald df Sig. Exp(B)

Step 0 Constant .000 .186 .000 1 1.000 1.000

Block 1: Method = Backward Stepwise (Wald)

Iteration Historya,b,c,d

Iteration

-2 Log

likelihood

Coefficients

Constant

HeartRate(

1) TDs Leukosit Hb Na LDL RDM

Step 1 1 129.331 -1.504 1.196 .806 .802 1.221 .643 -.067 -.080

2 127.585 -1.880 1.569 1.080 1.026 1.573 .737 .108 -.089

3 127.543 -1.942 1.640 1.128 1.063 1.635 .752 .149 -.091

(18)

5 127.543 -1.943 1.642 1.129 1.064 1.637 .752 .150 -.091

Step 2 1 129.363 -1.511 1.181 .803 .797 1.214 .632 -.084

2 127.618 -1.890 1.551 1.078 1.021 1.564 .728 .087

3 127.576 -1.952 1.621 1.126 1.058 1.627 .742 .127

4 127.576 -1.954 1.623 1.127 1.059 1.628 .743 .128

5 127.576 -1.954 1.623 1.127 1.059 1.628 .743 .128

Step 3 1 129.336 -1.515 1.160 .775 .791 1.217 .628

2 127.653 -1.885 1.568 1.103 1.026 1.559 .732

3 127.621 -1.939 1.637 1.157 1.062 1.614 .747

4 127.621 -1.940 1.639 1.158 1.063 1.615 .747

5 127.621 -1.940 1.639 1.158 1.063 1.615 .747

a. Method: Backward Stepwise (Wald)

b. Constant is included in the model.

c. Initial -2 Log Likelihood: 160.810

d. Estimation terminated at iteration number 5 because parameter estimates changed by less than .001.

Omnibus Tests of Model Coefficients

Chi-square Df Sig.

Step 1 Step 33.268 7 .000

Block 33.268 7 .000

Model 33.268 7 .000

Step 2a Step -.034 1 .854

Block 33.234 6 .000

Model 33.234 6 .000

Step 3a Step -.045 1 .833

Block 33.189 5 .000

Model 33.189 5 .000

a. A negative Chi-squares value indicates that the Chi-squares

value has decreased from the previous step.

Model Summary

Step -2 Log likelihood

Cox & Snell R

Square

Nagelkerke R

Square

1 127.543a .249 .332

(19)

3 127.621a .249 .332

a. Estimation terminated at iteration number 5 because parameter

estimates changed by less than .001.

Hosmer and Lemeshow Test

Step Chi-square df Sig.

1 4.361 7 .737

2 5.871 7 .555

3 4.699 7 .697

Contingency Table for Hosmer and Lemeshow Test

KKM = Tidak KKM KKM = KKM

Total Observed Expected Observed Expected

Step 1 1 11 11.187 2 1.813 13

2 4 5.215 3 1.785 7

3 14 14.839 7 6.161 21

4 8 7.016 3 3.984 11

5 11 8.088 4 6.912 15

6 4 4.332 6 5.668 10

7 3 3.521 9 8.479 12

8 2 2.239 10 9.761 12

9 1 1.560 14 13.440 15

Step 2 1 9 9.634 2 1.366 11

2 3 4.599 3 1.401 6

3 17 17.036 7 6.964 24

4 8 6.985 3 4.015 11

5 11 8.068 4 6.932 15

6 4 4.303 6 5.697 10

7 3 3.566 9 8.434 12

8 2 2.793 13 12.207 15

9 1 1.015 11 10.985 12

Step 3 1 9 9.618 2 1.382 11

2 3 4.603 3 1.397 6

(20)

4 4 3.589 2 2.411 6

5 12 9.582 6 8.418 18

6 4 4.058 7 6.942 11

7 2 2.255 6 5.745 8

8 1 1.846 9 8.154 10

9 2 1.969 15 15.031 17

Classification Tablea

Observed

Predicted

KKM

Percentage Correct Tidak KKM KKM

Step 1 KKM Tidak KKM 48 10 82.8

KKM 20 38 65.5

Overall Percentage 74.1

Step 2 KKM Tidak KKM 49 9 84.5

KKM 21 37 63.8

Overall Percentage 74.1

Step 3 KKM Tidak KKM 49 9 84.5

KKM 21 37 63.8

Overall Percentage 74.1

a. The cut value is .500

Variables in the Equation

B S.E. Wald df Sig. Exp(B)

95% C.I.for EXP(B)

Lower Upper

Step

1a

HeartRate(1) 1.642 .710 5.351 1 .021 5.166 1.285 20.772

TDs 1.129 .697 2.622 1 .105 3.094 .789 12.139

Leukosit 1.064 .543 3.834 1 .050 2.898 .999 8.409

Haemoglobin 1.637 .528 9.598 1 .002 5.140 1.825 14.479

KadarNatrium .752 .443 2.888 1 .089 2.122 .891 5.052

LDLdarah .150 .619 .059 1 .809 1.162 .345 3.907

RDM -.091 .498 .034 1 .855 .913 .344 2.421

(21)

Step

2a

HeartRate(1) 1.623 .702 5.344 1 .021 5.070 1.280 20.080

TDs 1.127 .697 2.616 1 .106 3.087 .788 12.099

Leukosit 1.059 .543 3.808 1 .051 2.884 .995 8.354

Haemoglobin 1.628 .525 9.603 1 .002 5.095 1.819 14.270

KadarNatrium .743 .439 2.859 1 .091 2.102 .889 4.972

LDLdarah .128 .607 .045 1 .832 1.137 .346 3.738

Constant -1.954 .553 12.488 1 .000 .142

Step

3a

HeartRate(1) 1.639 .698 5.508 1 .019 5.148 1.310 20.225

TDs 1.158 .683 2.878 1 .090 3.183 .835 12.128

Leukosit 1.063 .542 3.844 1 .050 2.895 1.000 8.380

Haemoglobin 1.615 .521 9.610 1 .002 5.027 1.811 13.953

KadarNatrium .747 .439 2.902 1 .088 2.111 .894 4.989

Constant -1.940 .548 12.533 1 .000 .144

a. Variable(s) entered on step 1: HeartRate, TDs, Leukosit, Haemoglobin, KadarNatrium,

LDLdarah, RDM.

Variables not in the Equation

Score df Sig.

Step 2a Variables RDM .034 1 .855

Overall Statistics .034 1 .855

Step 3b Variables LDLdarah .045 1 .832

RDM .020 1 .888

Overall Statistics .078 2 .962

a. Variable(s) removed on step 2: RDM.

Gambar

TABEL PENGOLAHAN DATA

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