HUBUNGAN ANTARA TANDA-TANDA GAGAL ORGAN MULTIPEL DENGAN KEMATIAN LANJUT PADA PENDERITA TRAUMA MAYOR ( THE RELATIONSHIP BETWEEN SIGNS OF MULTIPLE ORGAN FAILURE AND LATE DEATH ON MAJOR TRAUMA )

Abstract

Background : It had been recognized trimodal of death due to trauma i.e immediate death, early death and late death. Eighty percent of late death caused by infection and/or multiple organ failure (MOF). The study was aimed to predict late death from signs of MOF. material and methode : The study was conducted in patients admitted to Kariadi Hospital Semarang during June 2002 - May 2003 with major trauma who met the inclusion criteria, with cohort design Result : There were 84 patients with major trauma,35 from those faced the late death. Twenty patients (66,7%) of death cases showed signs of MOF before die. There was significant association between signs of MOF and late death with RR 5,2 ( 95% CI= 1,982-13,646). By Logistic Regression , it was proven that increasing of intracranial pressure as a covariate factor can not be neglected, because association with late death is significant with RR 7,93 (95% CI = 2,490 - 21,823). Conclusion : signs of MOF was significant associated with late death. Abstrak Latar belakang : Telah diketahui bahwa kematian akibat trauma mengikuti pola trimodal yaitu lcematian segera, kematian awal dan kematian lanjut . Delapan puluh persen dari kematian lanjut karena infeksi dan atau gagal organ multipel. Tujuan peneletian adalah memperkirakan kematian lanjut dari tanda-tanda gagal organ miltipel. Bahan dan cara : Penelitian dilakukan terhadap penderita yang datang di Rumah Sakit Kariadi Semarang yang datang pada periode Juni 2002-Mei 2003 dengan trauma mayor yang memenuhi kritreria inklusi. Disain penelitian adalah kohort. Hasd : Tercatat sebanyak 84 penderita dengan trauma mayor, 35 diantaranya mengalami late death. Dua puluh pasien (66,7%) mengalami tanda-tanda gagal organ multipel sebelum kematiannya . Diketahui hubungan yang bennakna antara gagal organ multipel kematian lanjut dengan RR = 5,2 (95% CI = 1,982-13,646). Regresi logistik menunjukkan bahwa faktor peningkatan TIK tidak dapat diabaikan karena dalam analisisnya memberikan RR =7,93 (95% CI = 2,490 - 21, 823). Kesimpulan : terdapat hubungan antara tanda-tanda gagal organ multipel dengan kematian lanjut.