Klasifikasi Modified World Health Organization sebagai Prediktor Mortalitas Ibu Hamil dengan Penyakit Jantung Pasca Persalinan dengan Analgesia/Anestesi
Abstract
Latar Belakang: Kelainan jantung merupakan penyebab utama tingginya angka kematian ibu hamil secara tidak langsung serta potensi luaran merugikan pada janin. Klasifikasi Modified World Health Organization (mWHO) digunakan sebagai sistem penilaian untuk mengidentifikasi komplikasi jantung selama kehamilan.
Tujuan: Menilai performa klasifikasi mWHO sebagai prediktor mortalitas ibu hamil dengan penyakit jantung pasca analgesia atau anestesi.
Subjek dan Metode: Study kohort retrospektif, data tahun 2019–2023. Performa diskriminasi dengan menilai AUC serta cut off ROC, kalibrasi dengan Hosmer-Lemeshow. Analisis Bivariat memprediksi hubungan mWHO dan variabel perancu terhadap mortalitas dilanjutkan analisis multivariat dengan uji regresi logistik. Signifikan jika p<0,05.
Hasil: Didapatkan 123 subjek rerata usia 29,54 tahun, angka kematian 8,1%. AUC 0,756 (95% IK = 0,645 – 0,866) p = 0,007, dengan Cut-off point terbaik pada klasifikasi mWHO kelas III dengan sensitivitas 70%, spesifisitas 70,8%. Uji kalibrasi (HL p= 0,262) dan hasil uji regresi logistik analisis multivariat (p = 0,04; OR = 5,802).
Simpulan: Klasifikasi mWHO memiliki performa diskriminasi dan kalibrasi yang valid sebagai prediktor mortalitas maternal yang signifikan pada pasien ibu hamil dengan penyakit jantung pasca persalinan dengan analgesia/anestesia
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Jurnal Anestesi Obstetri Indonesia
