Skip to main content Skip to main navigation menu Skip to site footer

Hubungan antara sepsis dan kejadian sindroma delirium pada penderita lanjut usia dengan penyakit infeksi di Instalasi Gawat Darurat RSUP Sanglah Denpasar



Abstract

Pendahuluan: Sindroma delirium pada lanjut usia masih merupakan problem kesehatan karena meningkatkan resiko kematian dan memperpanjang masa rawat pada pasien lanjut usia. Diperkirakan sekitar 10-30% pasien lanjut usia yang datang ke unit gawat darurat menderita sindroma delirium. Sepsis merupakan kumpulan gejala dari respon in amasi sistemik akibat infeksi dan sering dihubungkan dengan kejadian sindroma delirium pada penderita lanjut usia. Studi ini bertujuan untuk mencari hubungan antara sepsis dengan kejadian sindroma delirium pada penderita lanjut usia dengan penyakit infeksi yang datang di Instalasi Gawat Darurat RSUP sanglah.

Bahan dan Metode: Studi ini menggunakan potong lintang analitik observasional pada 60 penderita lanjut usia (usia ≥60 tahun) dengan penyakit infeksi yang datang Instalasi Gawat Darurat RSUP Sanglah periode Januari 2015 sampai dengan April 2015.

Hasil: Sampel penelitian berjumlah 60 orang, dengan lelaki sebanyak 39 orang (65%) dan perempuan 21 orang (35%) serta rerata usia 72,31±8,35 tahun. Infeksi paru didapatkan pada 35 kasus (58,3%), infeksi saluran kemih pada 10 kasus (16,7%), infeksi saluran cerna 5 kasus (8,3%), infeksi saluran empedu 3 kasus (5%) dan infeksi kulit dan soft tissue 7 kasus (11,7%). Kejadian sindroma delirium pada pasien sepsis sebesar 16 kasus (84,2%) sedangkan kejadian sindroma delirium pada pasien tanpa sepsis sebesar 3 kasus (15,8%).Uji Pearson Chi-Square menunjukkan hasil bermakna (P< 0,05).

Kesimpulan: Sepsis berhubungan dengan kejadian sindrom delirium pada penderita lanjut usia dengan penyakit infeksi yang datang ke Instalasi Gawat Darurat RSUP Sanglah Denpasar.


Introduction: Delirium syndrome in elderly is still a health problem because it increases the risk of death and hospital’s length of stay. It is estimated that approximately 10-30% of elderly people who come to the emergency department su er from delirium syndrome. Sepsis is a collection of symptoms of the systemic in ammatory response due to infection and related to delirium syndrome in elderly patients. This study is intended to nd the relationship between sepsis with the incidence of delirium syndrome in the elderly patients with infectious diseases that come to the emergency ward of Sanglah General Hospital.

Method: An analytical cross-sectional study was performed in 60 elderly patients (≥60 years old) with infectious diseases that come to Emergency Ward of Sanglah General Hospital from January 2015 to April 2015.

Result: The sample was 60 people, which is consist of 39 men (65%) and 21 women (35%). The mean age for this study is 72,31±8,35 years old. Lung infections were occured in 35 cases (58.3%), 10 cases (16.7%) with urinary tract infections, 5 cases (8.3%) with gastrointestinal infections, 3 cases (5%) with bile duct infections and 7 cases (11.7%) skin and soft tissue infection. The incidence of delirium syndrome in sepsis patients was 16 cases (84.2%) while the incidence of delirium syndrome in patients without sepsis was 3 cases (15.8%). The Pearson Chi-Square test showed signi cant results (P <0.05).

Conclusion: Sepsis is associated with the incidence of delirium syndrome in elderly patients with infectious diseases that come to the emergency ward of Sanglah General Hospital.

Keywords: sepsis delirium syndrome elderly patient infectious disease

References

  1. Gower LE, Gatewood MO, Kang CS. Emergency depart- ment management of delirium in the elderly. e western journal of emergency medicine. 2012;13(2):194-201.
  2. Hustey FM, Meldon SW. e prevalence and documen- tation of impaired mental status in elderly emergency department patients. Annals of emergency medicine. 2002;39(3):248-53.
  3. Hustey FM, Meldon SW, Smith MD, Lex CK. e e ect of mental status screening on the care of elderly emergency department patients. Annals of emergency medicine. 2003;41(5):678-84.
  4. McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E. Delirium predicts 12-month mortality. Archives of internal medicine. 2002;162(4):457-63.
  5. Ryan DJ, O'Regan NA, Caoimh RO, Clare J, O'Connor M, Leonard M, dkk. Delirium in an adult acute hospital pop- ulation: predictors, prevalence and detection. BMJ open. 2013;3(1):1-10
  6. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, dkk. De nitions for sepsis and organ failure and guidelines for the use of innovative therapies in sep- sis. e ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101(6):1644-55.
  7. Nasa P, Juneja D, Singh O. Severe sepsis and septic shock in the elderly: An overview. World journal of critical care medicine. 2012;1(1):23-30.
  8. Wass S, Webster PJ, Nair BR. Delirium in the elderly: a review. Oman medical journal. 2008;23(3):150-7.
  9. Schrader SL, Wellik KE, Demaerschalk BM, Caselli RJ, Woodru BK, Wingerchuk DM. Adjunctive haloperi- dol prophylaxis reduces postoperative delirium severity and duration in at-risk elderly patients. e neurologist. 2008;14(2):134-7.
  10. Girard TD, Opal SM, Ely EW. Insights into severe sepsis in older patients: from epidemiology to evidence-based management. Clinical infectious diseases : an o cial pub- lication of the Infectious Diseases Society of America. 2005;40(5):719-27.
  11. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical care medicine. 2001;29(7):1303-10.
  12. Siddiqi N, House AO, Holmes JD. Occurrence and out- come of delirium in medical in-patients: a systematic liter- ature review. Age and ageing. 2006;35(4):350-64.
  13. Martin GS, Mannino DM, Moss M. e e ect of age on the development and outcome of adult sepsis. Critical care medicine. 2006;34(1):15-21.
  14. De Gaudio AR, Rinaldi S, Chelazzi C, Borracci T. Pathophysiology of sepsis in the elderly: clinical impact and therapeutic considerations. Current drug targets. 2009;10(1):60-70.

How to Cite

Lasmono, C., Aryana, I. S., Kuswardhani, T., Astika, N., Putrawan, I., & Purnami, K. R. (2019). Hubungan antara sepsis dan kejadian sindroma delirium pada penderita lanjut usia dengan penyakit infeksi di Instalasi Gawat Darurat RSUP Sanglah Denpasar. Medicina, 50(2). https://doi.org/10.15562/medicina.v50i2.227
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
99

Total
30

Share