Hubungan Length of Stay dengan Mortalitas pada Pasien dengan Ventilasi Mekanik dan Trakeostomi
Kata Kunci:
Intensive care unit, length of stay, mortalitas, trakeostomi, ventilasi mekanikAbstrak
Pasien yang dirawat di Intensive Care Unit (ICU) dengan ventilasi mekanik dan trakeostomi memiliki mortalitas dan penggunaan sumber daya yang tinggi. Length of stay (LOS) merupakan indikator kualitas pelayanan dan efisiensi perawatan yang penting. Namun, hubungan antara LOS dan mortalitas masih menunjukkan hasil bervariasi. Artikel ini merupakan tinjauan pustaka mengenai konsep LOS, mortalitas pasien ICU, penggunaan ventilasi mekanik, trakeostomi, serta faktor yang memengaruhi hubungan LOS dan mortalitas. Data diperoleh dari berbagai penelitian mengenai luaran klinis pasien ICU. LOS yang lebih panjang berhubungan dengan peningkatan mortalitas, terutama akibat risiko komplikasi tinggi seperti ventilator-associated pneumonia (VAP), barotrauma, dan ventilator dependence. Mortalitas pada pasien dengan ventilasi mekanik dilaporkan sekitar 54,74% dan mencerminkan derajat keparahan penyakit yang tinggi. Trakeostomi dapat membantu proses weaning ventilator, meningkatkan kenyamanan pasien, dan menurunkan LOS, tetapi sebagian besar penelitian tidak menunjukkan penurunan mortalitas yang bermakna antara trakeostomi dini dan lambat. Faktor usia lanjut, sepsis, Multiple Organ Dysfunction Syndrome (MODS), penggunaan vasopressor, dan komorbiditas memiliki pengaruh yang lebih kuat terhadap mortalitas dibandingkan LOS sendiri. LOS memiliki hubungan dengan mortalitas pada pasien ICU dengan ventilasi mekanik dan trakesotomi, namun hubungan tersebut kompleks dan multifaktorial serta bukan prediktor mortalitas independent. LOS perlu diinterpretasikan bersama parameter klinis lain
Unduhan
Referensi
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