Perbandingan Komplikasi, Mortalitas, dan Lama Rawat Pasien Stroke yang Dilakukan Trakeostomi Dilatasional Perkutan dan Trakeostomi Surgikal di RSUP Dr. Mohammad Hoesin Palembang
DOI:
https://doi.org/10.58344/jii.v5i8.7977Keywords:
stroke, trakeostomi dilatasional perkutan, trakeostomi surgikal, komplikasi, mortalitas, lama rawatAbstract
Stroke merupakan sindroma klinis dengan angka kejadian sekitar 12 per 1.000 orang di Indonesia yang sering memerlukan perawatan di Intensive Care Unit (ICU). Trakeostomi dibagi menjadi dua jenis, yaitu Trakeostomi Dilatasional Perkutan (TDP) dan trakeostomi surgikal. Hingga kini, belum ada panduan khusus mengenai pilihan teknik trakeostomi paling tepat untuk pasien stroke. Penelitian ini bertujuan menganalisis perbandingan komplikasi, mortalitas, dan lama rawat pasien stroke yang menjalani TDP dan trakeostomi surgikal di RSUP Dr. Mohammad Hoesin Palembang. Penelitian ini menggunakan desain observasional analitik dengan pendekatan kohort prospektif di Ruang Perawatan Intensif, Neuro High Care Unit, dan Stroke Unit RSUP Dr. Mohammad Hoesin Palembang. Sebanyak 30 pasien stroke berusia ?18 tahun yang memenuhi kriteria inklusi diikutsertakan, terdiri dari 18 subjek kelompok TDP dan 12 subjek kelompok trakeostomi surgikal. Tidak terdapat perbedaan bermakna dalam karakteristik dasar antara kedua kelompok (p>0,05). Kelompok TDP menunjukkan risiko perdarahan minor yang lebih rendah secara bermakna (p=0,015), begitu pula komplikasi infeksi stoma (p=0,015), dibandingkan kelompok trakeostomi surgikal. Tidak terdapat perbedaan bermakna pada kejadian perdarahan mayor (p>0,05) dan malposisi kanul trakeostomi (p=0,804) antara kedua kelompok. Pada luaran mortalitas, tidak terdapat perbedaan bermakna secara statistik antara kelompok TDP (11,1%) dan trakeostomi surgikal (41,7%) (p=0,084). Demikian pula, tidak terdapat perbedaan bermakna pada lama rawat antara kedua kelompok (p>0,05). TDP memiliki risiko perdarahan minor dan infeksi stoma yang lebih rendah dibandingkan trakeostomi surgikal pada pasien stroke, dengan mortalitas dan lama rawat yang sebanding. Temuan ini dapat menjadi pertimbangan klinis dalam pemilihan teknik trakeostomi pada pasien stroke yang memerlukan manajemen jalan napas jangka panjang.
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