Research Article

Faktor-faktor yang berhubungan dengan terjadinya hipertensi intraabdominal pada pasien dengan peritonitis di RSUP Sanglah Denpasar dari bulan Januari 2017 - Desember 2018

Krishna Kurnia Pratama , Ketut Sudiasa, Nyoman Golden

Krishna Kurnia Pratama
PPDS-1 Ilmu Bedah, Fakultas Kedokteran Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia. Email: kpratama26@gmail.com

Ketut Sudiasa
Divisi Bedah Trauma, Departemen/KSM Ilmu Bedah, Fakultas Kedokteran Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia

Nyoman Golden
Departemen/KSM Bedah Saraf, Fakultas Kedokteran Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia
Online First: August 01, 2020 | Cite this Article
Pratama, K., Sudiasa, K., Golden, N. 2020. Faktor-faktor yang berhubungan dengan terjadinya hipertensi intraabdominal pada pasien dengan peritonitis di RSUP Sanglah Denpasar dari bulan Januari 2017 - Desember 2018. Intisari Sains Medis 11(2): 814-822. DOI:10.15562/ism.v11i2.723


Background and aim: Peritonitis is an emergency condition in the field of surgery due to its several complications. The most challenging is intraabdominal hypertension which can develop into abdominal compartment syndrome. There are several factors that cause intraabdominal hypertension in patients with peritonitis. This study aims to found factors that are associated with the occurrence of intraabdominal hypertension in peritonitis patients at Sanglah General Hospital in January 2017-December 2018.

Method: This research used cross sectional analitic with total sampling technique with 136 peritonitis patients in Sanglah Hospital from Januari 2017 until December 2018 as respondents. Data source obtained from medical report. Bivariat analysis done to find factors related with intraabdominal hypertension in peritonitis patients with chi square method and multivariate analysis with logistic regression.

Result: The majority of respondents are male, aged 15-64 years, organs involved in peritonitis in the form of solid organs, peritonitis that occurs through trauma mechanisms, experiencing sepsis, leukocytosis, and not hypoalbumin. Three variables were found to be significantly related they are, peritonitis caused by hollow organ perforation, sepsis condition, and hypoalbumin conditions. Only the sepsis condition has significant relationship with the occurrence of intraabdominal hypertension. Sepsis is 0.262 times more likely to cause intraabdominal hypertension in patients with peritonitis compared to patients without sepsis.

Suggestion: Closely monitoring intraabdominal pressure should be carried out, especially in patients with sepsis, hypoalbumin, and those suspected of having perforations in hollow organs and further research is needed with a larger number of samples and more superior research methods.

 

Latar belakang dan tujuan: Peritonitis merupakan kondisi kegawatdaruratan di bidang bedah karena dapat menyebabkan terjadinya beberapa komplikasi salah satu yang terberat adalah hipertensi intraabdominal yang dapat berkembang menjadi sindrom kompartemen abdomen. Terdapat beberapa faktor yang menyebabkan hipertensi intraabdominal pada pasien peritonitis. Penelitian ini bertujuan untuk melihat faktor-faktor yang berhubungan dengan terjadinya hipertensi intraabdominal pada pasien peritonitis di RSUP Sanglah bulan Januari 2017-Desember 2018.

Metode: Penelitian analitik cross sectional dilakukan menggunakan teknik total sampling dengan melibatkan 136 responden yang merupakan pasien peritonitis yang dirawat di RSUP Sanglah bulan Januari 2017-Desember 2018. Sumber data berupa rekam medis pasien. Analisis dilakukan untuk melihat faktor yang berhubungan dengan hipertensi intraabdominal pada pasien peritonitis secara bivariat dengan metode chi square dan multivariat dengan regresi logistik.

Hasil: Mayoritas responden berjenis kelamin laki-laki, berusia 15-64 tahun, organ terlibat dalam peritonitis berupa organ padat, peritonitis yang terjadi melalui mekanisme trauma, mengalami sepsis, leukositosis, dan tidak hipoalbumin. Tiga variabel ditemukan signifikan berhubungan yakni peritonitis diakibatkan oleh perforasi organ berongga, kondisi sepsis, dan kondisi hipoalbumin. Hanya kondisi sepsis yang memiliki hubungan murni dengan terjadinya hipertensi intraabdominal. Kondisi sepsis berisiko 0,262 kali lebih besar menyebabkan terjadinya hipertensi intraabdominal pada pasien peritonitis dibandingkan dengan pasien yang tidak mengalami sepsis.

Saran: Sebaiknya dilakukan pemantauan tekanan intraabdominal secara ketat, terutama pada pasien dengan sepsis, hipoalbumin, dan yang dicurigai mengalami perforasi pada organ berongga serta diperlukan penelitian lanjutan dengan jumlah sampel yang lebih besar serta metode penelitian yang lebih superior.

 

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