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Faktor-faktor pasca operasi satu tahap yang mempengaruhi kejadian hirschsprung associated enterocolitis pada pasien hirschsprung disease

  • Elika Larasati ,
  • I Made Darmajaya ,
  • Nyoman Golden ,

Abstract

Background: Hirschsprung-Associated Enterocolitis (HAEC) is a life-threatening consequence of Hirschsprung Disease (HD) that was initially documented in the late 19th century. The occurrence of HAEC did not exhibit any changes from the preoperative phase to the postoperative phase and can manifest at any point from infancy to adulthood. To date, no research has been conducted on the factors influencing the occurrence of HAEC in Hirschsprung patients who undergo a one-stage procedure. Thus, this study aims to investigate the factors that influence the occurrence of HAEC in patients with Hirschsprung’s disease after undergoing a one-stage operation.

Methods: This study is a retrospective cohort study. The study was carried out at RSUP Prof. Dr. I G.N.G. Ngoerah Denpasar Bali, examining the medical records of pediatric surgery patients for a period of three years (January 2019 to December 2021). Descriptive and bivariate statistical analyses are conducted. The bivariate test employed is the Chi Square Test, utilizing the assistance of statistical software called SPSS (Statistical Package for the Social Sciences) version 25.0.

Results: The overall sample based on gender was 42 (75%) male patients in the HAEC group and 33 (63.5%) in the non-HAEC group. The findings of statistical analysis demonstrate that the difference between these groups is (p=0.193) with an RR value of 1.320 (95%CI: 0.846 – 2.060). The findings of the examination of the connection between patient age at diagnosis and the incidence of HAEC indicated that there were 39 (69.9%) patients with age >1 month at diagnosis in the HAEC group and 26 (50%) in the non-HAEC group. Based on analysis utilizing chi-square, a significant difference in percentage was discovered between patients aged < 1.5 months and above 1.5 months regarding the occurrence of HAEC (p=0.037). Multivariate analysis indicated significant findings for the variable age at diagnosis with an RR of 2.610 (95%CI: 1.129–6.031; p<0.05) while the lengthy segment had an RR of 12.702 (95%CI: 1.142 – 111.916; p<0.05).

Conclusion: Patients with long segments and are diagnosed after 1 month of age have a higher chance of HAEC.

 

Pendahuluan: Hirschsprung-associated enterocolitis (HAEC) merupakan komplikasi dari Hirschsprung disease (HD) yang mengancam nyawa dan pertama kali dideskripsikan pada akhir abad ke-19. HAEC dapat bermanifestasi kapan saja mulai dari bayi hingga dewasa. Sampai saat ini belum ditemukan adanya penelitian mengenai faktor-faktor yang mempengaruhi terjadinya HAEC pada pasien Hirschsprung yang menjalani prosedur satu tahap. Oleh karena itu, penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi terjadinya HAEC pada pasien penyakit Hirschsprung setelah menjalani operasi satu tahap.

Metode: Penelitian ini merupakan penelitian kohort retrospektif. Penelitian dilakukan di RSUP Prof.Dr. I G.N.G. Ngoerah Denpasar Bali, menggunakan rekam medis pasien bedah anak periode tiga tahun (Januari 2019 – Desember 2021). Analisis statistik deskriptif dan bivariat dilakukan. Uji bivariat yang digunakan adalah Uji Chi-square dengan menggunakan bantuan software statistik SPSS (Statistical Package for the Social Sciences) versi 25.0.

Hasil: Total sampel berdasarkan jenis kelamin adalah sebesar 42 (75%) pasien laki-laki pada kelompok HAEC dan 33 (63,5%) pada kelompok non-HAEC. Hasil analisis statistik menunjukkan bahwa perbedaan diantara kelompok ini (p=0,193) dengan nilai RR sebesar 1,320 (95%CI: 0,846 – 2,060). Hasil analisis hubungan antara usia pasien saat diagnosis dengan kejadian HAEC terdapat 39 (69,9%) pasien dengan usia >1 bulan saat diagnosis pada kelompok HAEC dan 26 (50%) pada kelompok non-HAEC. Berdasarkan analisis dengan menggunakan chi-square, didapatkan perbedaan proporsi yang signifikan antara pasien dengan usia dibawah 1,5 bulan dan diatas 1,5 bulan terhadap kejadian HAEC (p=0,037). Analisis multivariat menunjukan hasil yang signifikan pada variabel usia terdiagnosis RR 2,610 (95%CI: 1,129–6,031; p<0,05) sementara long segment sebesar RR 12,702 (95%CI: 1,142 – 111,916; p<0,05).

Simpulan: Pasien dengan segmen yang panjang dan pasien yang terdiagnosis setelah usia 1 bulan memiliki risiko yang lebih tinggi mengalami HAEC.

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How to Cite

Larasati, E., Darmajaya, I. M. ., & Golden, N. . (2024). Faktor-faktor pasca operasi satu tahap yang mempengaruhi kejadian hirschsprung associated enterocolitis pada pasien hirschsprung disease. Intisari Sains Medis, 15(1), 103–108. https://doi.org/10.15562/ism.v15i1.1940

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