Faktor risiko kejadian dengue shock syndrome pada anak di RSUD Sanjiwani Gianyar periode Januari 2021 sampai September 2022
Authors: Rajani Anak Agung Puteri Indira , Windiyanto Romy 
Published: November 2023

Background: Early detection and proper management are crucial to prevent rapid mortality caused by severe dengue, particularly in children, and it is essential to identify potential risk factors that may lead to dengue shock syndrome (DSS) to anticipate and manage potential worsening in pediatric patients. This study aims to evaluate the factors associated with the development of DSS in children with dengue.
Methods: Between January 2021 and September 2022, a cross-sectional study was conducted at the Sanjiwani Regional General Hospital in Gianyar City. The study involved the use of secondary data from medical records of pediatric patients aged 0-18 years, who were diagnosed with dengue during the period under investigation. The variables of age, gender, nutritional status, abdominal pain, persistent vomiting, bleeding, leukocyte levels, hemoglobin, hematocrit, platelets, and hemoconcentration were analyzed for their association with the prevalence of DSS.
Results: The study subjects were 62 children who met the criteria. A total of 31 (50%) patients were diagnosed with DSS. The results of this study indicate that the factors that have an association with the incidence of DSS in children at Sanjiwani Gianyar Hospital are age (p=0.038; prevalence ratio [PR]=0.359), nutritional status (p=0.020; PR=1.897), abdominal pain (p=0.038; PR=2.154), platelet levels (p=0.046; PR=1.672), and the presence of hemoconcentration (p=0.002; PR=2.122). 
Conclusion: Age,  nutritional status, abdominal pain, platelet levels, and hemoconcentration factors were found to be associated with the incidence of DSS.
 
Latar belakang: Severe dengue dapat menyebabkan kematian yang cepat terutama pada anak-anak jika tidak terdeteksi sejak dini dan dikelola dengan baik. Mengidentifikasi faktor-faktor risiko yang berpotensi mempengaruhi dengue shock syndrome (DSS) penting untuk mengantisipasi dan mengelola potensi perburukan pada pasien anak. Penelitian ini bertujuan mengevaluasi faktor-faktor yang berkontribusi dalam perkembangan DSS pada anak-anak dengan dengue.
Metode: Penelitian cross-sectional dilakukan menggunakan data sekunder dari rekam medik di Rumah Sakit Umum Daerah (RSUD) Sanjiwani Gianyar, pada pasien anak berusia 0-18 tahun yang terinfeksi dengue dan dirawat pada periode Januari 2021-September 2022. Variabel usia, jenis kelamin, status gizi, nyeri perut, muntah persisten, perdarahan, kadar leukosit, hemoglobin, hematokrit, trombosit, dan hemokonsentrasi dianalisis hubungannya dengan kejadian DSS.
Hasil: Subyek penelitian sebanyak 62 sampel yang memenuhi kriteria. Sebanyak 31 (50%) pasien terdiagnosis DSS. Hasil penelitian ini menunjukkan bahwa faktor-faktor yang memiliki hubungan dengan kejadian DSS pada anak di RSUD Sanjiwani Gianyar yaitu usia (p=0,038; prevalence ratio [PR]=0,359), status gizi (p=0,020; PR=1,897), nyeri perut (p=0,038; PR=2,154), kadar trombosit (p=0,046; PR=1,672), dan adanya hemokonsentrasi (p=0,002; PR=2,122).
Kesimpulan: Faktor risiko yang ditemukan berhubungan dengan kejadian DSS meliputi usia, status gizi, nyeri perut, kadar trombosit, dan kejadian hemokonsentrasi.