Perbandingan Penilaian Revised Trauma Score dan Injury Severity Score dalam Memprediksi Mortalitas Pasien Cedera Kepala di IGD RSUD Dr. H. Moch Ansari Saleh
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Cedera kepala merupakan kondisi serius akibat trauma fisik eksternal yang dapat menurunkan kesadaran, fungsi kognitif, dan kemampuan fisik pasien. Penilaian tingkat keparahan cedera kepala sangat penting untuk menentukan prognosis, namun pemahaman serta penerapan sistem penilaian trauma oleh tenaga kesehatan masih terbatas. Dua instrumen yang banyak digunakan adalah Revised Trauma Score (RTS), yang menilai aspek fisiologis pasien, dan Injury Severity Score (ISS), yang menilai aspek anatomis. Penelitian ini bertujuan membandingkan kemampuan RTS dan ISS dalam memprediksi mortalitas pasien cedera kepala di Instalasi Gawat Darurat (IGD) RSUD dr. H. Moch Ansari Saleh. Penelitian menggunakan desain quasi experiment dengan rancangan one shot case study (post-test only design) dan melibatkan 30 responden yang dipilih dengan teknik accidental sampling. Data dikumpulkan melalui lembar observasi RTS dan ISS, kemudian dianalisis menggunakan uji Wilcoxon. Hasil penelitian menunjukkan nilai p = 0,001 < 0,05, yang berarti terdapat perbedaan signifikan antara RTS dan ISS dalam memprediksi mortalitas. Dari 30 pasien, 7 (23,3%) meninggal dan 23 (76,6%) selamat. RTS menilai 12 pasien (80,0%) dengan skor 37 bertahan hidup dan 3 pasien (20,0%) meninggal, sementara ISS menunjukkan 6 pasien (80,0%) dengan skor mortalitas rendah selamat dan 3 pasien (20,0%) dengan skor mortalitas tinggi meninggal. Dapat disimpulkan bahwa RTS dan ISS sama-sama konsisten dalam memprediksi mortalitas, namun RTS lebih praktis karena cepat diaplikasikan pada triase maupun survei awal, sehingga berpotensi dijadikan standar penilaian di layanan prehospital maupun rujukan.
Comparing Revised Trauma Score and Injury Severity Score in Predicting Mortality of Head Injury Patients at IGD Dr. H. Moch Ansari Saleh Banjarmasin
Abstract
Head injury is a serious condition caused by external physical trauma that can impair consciousness, cognitive function, and physical ability. Assessing the severity of head injury is crucial for determining prognosis, yet healthcare providers often have limited understanding and application of available trauma scoring systems. Two widely used instruments are the Revised Trauma Score (RTS), which evaluates the patient’s physiological status, and the Injury Severity Score (ISS), which evaluates anatomical conditions. This study aims to compare the effectiveness of RTS and ISS in predicting mortality among head injury patients in the Emergency Department (ED) of RSUD dr. H. Moch Ansari Saleh. The study employed a quasi-experimental design with a one shot case study (post-test only design) involving 30 respondents selected through accidental sampling. Data were collected using RTS and ISS observation sheets and analyzed with the Wilcoxon test. The results showed a p-value of 0.001 < 0.05, indicating a significant difference between RTS and ISS in predicting mortality. Of the 30 patients, 7 (23.3%) died and 23 (76.6%) survived. RTS classified 12 patients (80.0%) with a score of 37 as survivors and 3 patients (20.0%) as deceased, while ISS showed 6 patients (80.0%) with low mortality scores survived and 3 patients (20.0%) with high mortality scores died. In conclusion, both RTS and ISS were consistent in predicting mortality. However, RTS is more practical because it can be quickly applied during triage or initial assessment, making it a potential standard for prehospital and referral evaluations.
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