SKRIPSI
SKRIPSI
Diajukan Sebagai Salah Satu Syarat Untuk Memperoleh Gelar
Sarjana Kedokteran
ABSTRAK
Nila Paharagita Purnama
Abstrak
Kata kunci: Apendistis Akut, Perforasi, Skor Alvarado, Durasi Nyeri Abdomen
v
THE RELATION OF ALVARADO SCORE AND DURATION OF
ABDOMINAL PAIN WITH THE INCIDENCE OF PERFORATION IN
ACUTE APPENDICITIS PATIENTS AT PRESIDENTIAL HOSPITAL
GATOT SOEBROTO ARMY HOSPITAL JAKARTA IN 2016
ABSTRACT
Nila Paharagita Purnama
Abstract
Acute appendicitis is the most common cause of acute abdomen disease and the
most common emergency surgery. The main complication of acute appendicitis is
appendix perforation. Delay in making diagnosis and visiting the hospital can
increase the incidence of appendix perforation. Alvarado score and duration of
abdominal pain can improve to decrease the incidence of appendix perforation.
The study aim to determine the relation of Alvarado score and duration of
abdominal pain with the incidence of perforation in acute appendicitis patient at
presidential hospital Gatot Soebroto Army Hospital Jakarta in 2016. This study
used cross sectional design. The study used secondary data which is the medical
record with 72 patients were included by total sampling technique. The collected
data were analyzed by univariate and bivariate analyzes. The results showed that
incidence of perforation in acute appendicitis patients at Presidential Hospital
Gatot Soebroto Army Hospital Jakarta in 2016 is 29.2% with Alvarado score ≥ 7
and duration of abdominal pain > 24 hours . The results of Chi-Square statistic
test showed that there was significant association between Alvarado score
(p=0.000) and duration of abdominal pain (p=0.000) with the incidence of
perforation in acute appendicitis patient. Conclusion of the study is there was
association between Alvarado score and duration of abdominal pain with the
incidence of perforation in acute appendicitis patients.
vi
KATA PENGANTAR
Puji dan syukur saya panjatkan kehadirat Allah SWT atas segala karunia-Nya
sehingga skripsi yang berjudul “Hubungan Skor Alvarado dan Durasi Nyeri
Abdomen dengan Kejadian Perforasi pada Pasien Apendisitis Akut di RS
Kepresidenan RSPAD Gatot Soebroto Jakarta Tahun 2016” ini dapat diselesaikan
dengan baik. Pada kesempatan ini izinkan saya untuk menyampaikan rasa hormat
dan ucapan terimakasih yang mendalam kepada:
1. dr. Boediono Soehendro, Sp.B-KBD, selaku pembimbing 1 yang telah
meluangkan waktu, tenaga, dan pikiran selama membimbing dalam
penelitian ini.
2. dr. Yanti Harjono, MKM, selaku pembimbing 2 yang telah meluangkan
waktu, tenaga, dan pikiran selama membimbing dalam penelitian ini.
3. Dr. dr. Edy Sedyawan, M.Sc, selaku penguji pada sidang proposal dan
sidang skripsi saya, yang telah memberikan saran dan koreksi yang sangat
berarti sehingga skripsi ini dapat saya selesaikan dengan hasil yang lebih
baik.
4. Dr. dr. Prijo Sidipratomo, Sp. Rad (K), selaku Dekan Fakultas Kedokteran
Universitas Pembangunan Nasional “Veteran” Jakarta.
5. dr. Niniek Hardini, Sp.PA, selaku Ka Prodi Sarjana Kedokteran
Universitas Pembangunan Nasional “Veteran” Jakarta.
6. Seluruh staf dosen pengajar di Fakultas Kedokteran FK UPN “Veteran”
Jakarta yang telah berkenan membimbing dan membagi ilmunya selama
pendidikan kepada saya.
7. Seluruh staf di Instalasi Gawat Darurat, Instalasi Kamar Operasi, Rekam
Medik RS Kepresidenan RSPAD Gatot Soebroto Jakarta yang telah
membantu saya dalam pengambilan data.
8. Kedua orang tua dan adik saya yang selalu memberikan motivasi,
dukungan, semangat dan nasihat yang tak henti – hentinya kepada saya.
9. Boby Santoso Freedantius yang selalu memberikan dukungan dan
semangat.
vii
10. Teman seperjuangan dan seperbimbingan dr. Yanti, Tiara Nadya
Putrianda.
11. Teman – teman seperjuangan FK UPN angkatan 2014.
12. Kakak dan Adik NRP 148, Bang Putra, Kak Laresi, Bang Dondy, Kak
Fanni, Bang Septa, Kak Ratu, Winda, Agung, Risa.
13. Semua teman-teman yang tidak bisa saya sebutkan satu persatu yang
selalu mengingatkan, menyemangati, membantu dan mendoakan saya
untuk menyelesaikan skripsi ini.
Akhir kata, penulis berharap kerja keras yang tertuang dalam skripsi ini dapat
bermanfaat bagi banyak pihak.
viii
DAFTAR ISI
HALAMAN JUDUL................................................................................................ i
PERNYATAAN ORISINALITAS ......................................................................... ii
PERNYATAAN PERSETUJUAN PUBLIKASI .................................................. iii
PENGESAHAN ..................................................................................................... iv
ABSTRAK .............................................................................................................. v
ABSTRACT ..............................................................................................................vi
KATA PENGANTAR .......................................................................................... vii
DAFTAR ISI .......................................................................................................... ix
DAFTAR TABEL .................................................................................................. xi
DAFTAR GAMBAR ............................................................................................ xii
DAFTAR BAGAN .............................................................................................. xiii
DAFTAR LAMPIRAN ........................................................................................ xiv
BAB I PENDAHULUAN ...................................................................................... 1
I.1 Latar Belakang ................................................................................................... 1
I.2 Rumusan Masalah .............................................................................................. 3
I.3 Tujuan Penelitian ............................................................................................... 4
I.4 Manfaat Penelitian ............................................................................................. 4
BAB II TINJAUAN PUSTAKA............................................................................. 6
II.1 Landasan Teori ................................................................................................. 6
II.2 Kerangka Teori ............................................................................................... 31
II.3 Kerangka Konsep ........................................................................................... 32
II.4 Hipotesis Penelitian ........................................................................................ 32
II.5 Penelitian yang Relevan ................................................................................. 33
BAB III METODE PENELITIAN........................................................................ 36
III.1 Desain Penelitian ........................................................................................... 36
III.2 Waktu dan Lokasi Penelitian......................................................................... 36
III.3 Subjek Penelitian ........................................................................................... 36
III.4 Besar Sampel ................................................................................................. 38
III.5 Teknik Sampling ........................................................................................... 39
III.6 Rancangan Penelitian .................................................................................... 40
ix
III.7 Identifikasi Variabel Penelitian ..................................................................... 40
III.8 Definisi Operasional ...................................................................................... 41
III.9 Instrumen Penelitian ...................................................................................... 42
III.10 Cara Kerja Penelitian .................................................................................. 42
III.11 Pengolahan Data dan Analisis Data ............................................................ 43
III.12 Etika Penelitian ........................................................................................... 45
III.13 Alur Penelitian............................................................................................. 46
BAB IV HASIL DAN PEMBAHASAN .............................................................. 47
IV.1 Gambaran Umum RS Kepresidenan RSPAD Gatot Soebroto ...................... 47
IV.2 Analisis Hasil Penelitian ............................................................................... 48
IV.3 Pembahasan................................................................................................... 54
IV.4 Keterbatasan Penelitian ................................................................................. 60
BAB V KESIMPULAN DAN SARAN ................................................................ 62
V.1 Kesimpulan ..................................................................................................... 62
V.2 Saran ............................................................................................................... 62
DAFTAR PUSTAKA ........................................................................................... 64
RIWAYAT HIDUP
LAMPIRAN
x
DAFTAR TABEL
xi
DAFTAR GAMBAR
xii
DAFTAR BAGAN
xiii
DAFTAR LAMPIRAN
xiv