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ABSTRAKDemam Berdarah Dengue (DBD) merupakan salah satu penyakit menular yang bersifat endemis di Indonesia. DBD dapat bermanifestasi klinis menjadi Dengue Shock Syndrome (DSS) yang dapat mengakibatkan kematian pada penderita. Berdasarkan data surveilans kota Medan tahun 2014 terdapat 1.699 kasus DBD. Tujuan penelitian ini adalah mengetahui karakteristik penderita DBD dengan DSS dan Non DSS, penelitian dilakukan di RSUD Dr. Pirngadi Medan dengan desain case series.
Populasi pada penelitian ini berjumlah 120 orang pada tahun 2013-2015 yang tercatat di rekam medis. Sampel penelitian diambil dengan purposive sampling dengan kriteria ekslusi penderita DSS yang datang sudah dengan syok dikeluarkan dari sampel. Data univariat dianalisis secara deskriptif dan data bivariat dianalisis menggunakan Chi-Square dan Exact Fisher’s.
Berdasarkan sosiodemografi proporsi tertinggi penderita DSS pada kelompok umur <15 tahun dan jenis kelamin perempuan (61,9%), pendidikan rendah (90,0%), tidak bekerja (93,3%). Proporsi tertinggi menurut tanda-tanda perdarahan yaitu petekie (40,0%), jumlah trombosit saat datang ke RS <50.000/mm3 (76,7%), jumlah trombosit saat pulang dari RS ≥100.000/mm3
(96,7%), persentase hematokrit saat datang ke RS <40% (53,3%), persentase hematokrit pada saat pulang dari RS <40% (73,4%), pemberian cairan kristaloid (46,7%), lama rawatan rata-rata penderita DSS 7 hari, PBJ (90,0%). Terdapat perbedaan yang bermakna antara jumlah trombosit pada saat datang ke RS pada penderita DSS dan Non DSS (p=0,001). Tidak terdapat perbedaan yang bermakna antara jumlah trombosit pada saat pulang dari RS pada penderita DSS dan Non DSS. Tidak terdapat perbedaan yang bermakna antara persentase hematokrit pada saat datang ke RS pada penderita DSS dan Non DSS. Tidak terdapat perbedaan yang bermakna antara jumlah trombosit penderita saat datang ke RS dengan keadaan sewaktu pulang. Tidak terdapat perbedaan yang bermakna antara persentase hematokrit penderita saat datang ke RS dengan keadaan sewaktu pulang (p>0,05).
Disarankan kepada pihak RSUD Dr. Pirngadi Medan untuk memberikan informasi kepada keluarga penderita DBD untuk memerhatikan kondisi pasien pada saat dirawat agar terhindar dari DSS.
Kata Kunci: DBD, karakteristik penderita, DSS dan Non DSS
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ABSTRACT
Dengue Hemorrhagic Fever (DHF) is contagious disease that endemic in Indonesia. DHF can clinically manifest into dengue shock syndrome (DSS), which can lead into death. Surveillance data Medan in 2014 there were 1,699 cases of dengue. The purpose of this study to determine the characteristics of DHF patients with DSS and Non DSS, the study conducted at RSUD Dr. Pirngadi Medan with case series design.
The number of population in 2013 to 2015 were 120 people and recorded in medical record. Samples were taken by purposive sampling with exclusion criteria for patients with DSS who come already with shock were excluded from the sample. Univariate data were analyzed descriptively and bivariate data were analyzed using
Chi-square and Exact Fisher’s.
Based on the sociodemographic, the highest proportion of DSS patients is in the age group < 15 years and female (61,9%), low education (90,0%), unemployment (93,3%). The highest proportion according to the signs of hemorrhage namely petechial (40,0%), the platelet count when it comes to the hospital < 50.000/mm3 (76.7%), the
number of platelets on go back from hospital ≥100.000 /mm3 (96.7%), hematocrit percentage when it comes to hospital < 40% (53.3%), the percentage of hematocrit on go back from hospital < 40% (73.4%), crystalloid fluid administration (46,7%), length of day of DSS patient was 7 days, outpatient (90,0%). There was a significant difference between the number of platelets when it comes to hospital in patients with DSS and Non DSS (p= 0,001). There was no significant difference between number of platelets on go back home from hospital in patients with DSS and Non DSS. There was no significant difference between hematocrit percentage when it comes to hospital in patients with DSS and Non DSS. There was no significant difference between patients with platelet counts when it comes to hospital with circumstances when home. There was no significant difference between patient with hematocrit percentage of patients when it comes to the hospital with circumstances when home (p> 0,05).
It was suggested to RSUD Dr. Pirngadi Medan to provide information to families of DHF patients to pay attention to the patient's condition in order to avoid DSS.
Keywords: DBD, patient characteristics, DSS and Non DSS
