KORELASI SISTEM PENILAIAN TRAUMA AND INJURY

SEVERITY SCORE (TRISS) DAN PROGNOSIS PASIEN

TRAUMA DI RUMAH SAKIT TK II Dr. SOEPRAOEN KOTA

MALANG

SKRIPSI

Oleh :

CHUSNUL CHATIMAH

NIM. 201510420311148

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH MALANG

2019

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KORELASI SISTEM PENILAIAN TRAUMA AND INJURY

SEVERITY SCORE (TRISS) DAN PROGNOSIS PASIEN

TRAUMA DI RUMAH SAKIT TK II Dr. SOEPRAOEN KOTA

MALANG

SKRIPSI

Untuk Memenuhi Sebagai Persyaratan Mencapai Derajat Sarjana Keperawatan

(S.Kep) Pada Program Studi Ilmu Keperawatan Fakultas Ilmu Kesehatan Universitas

Muhammadiyah Malang

Oleh :

CHUSNUL CHATIMAH

NIM. 201510420311148

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH MALANG

2019

ii

iii

iv

v

KATA PENGANTAR

Assalamu’alaikum Wr. Wb

Puji syukur saya panjatkan kepada Allah SWT, karena atas limpahan rahmat-

Nya saya dapat menyelesaikan skripsi yang berjudul “Korelasi Sistem Penilaian

Trauma and Injury Severity Score (TRISS) Dan Prognosis Pasien Trauma Di Rumah

Sakit TK II Dr. Soepraoen Kota Malang”. Penulisan skripsi ini dilakukan dalam

rangka memenuhi salah satu persyaratan awal untuk mencapai gelar sarjana

keperawatan (S.Kep) pada Program Studi Ilmu Keperawatan Fakultas Ilmu

Kesehatan Universitas Muhammadiyah Malang

Saya menyadari bahwa bantuan dan bimbingan dari berbagai pihak sangat

membantu dan memudahkan saya dalam rangka menyelesaikan skripsi ini. Oleh

karena itu, perkenankan saya mengucapkan terima kasih kepada :

1. Bapak Faqih Ruhyanuddin, M.Kep, Sp. Kep. MB selaku Dekan Fakultas

Ilmu Kesehatan Universitas Muhammadiyah Malang

2. Ibu Nurlailatul Masruroh, S.Kep.Ns, MNS selaku Ketua Program Studi

Ilmu Keperawatan Fakultas Ilmu Kesehatan Universitas Muhammadiyah

Malang

3. Bapak Zahid Fikri, M.Kep selaku Dosen Wali Program Studi Ilmu

Keperawatan- C 2015

4. Ibu Indah Dwi Pratiwi, M.Ng selaku Dosen Pembimbing I atas

bimbingan, dukungan serta kesabaran yang diberikan kepada saya selama

menyelesaikan naskah skripsi ini

5. Bapak Chairul Huda Al Husna, M.Kep selaku Dosen Pembimbing II

atas bimbingan, motivasi dan kesabaran yang diberikan kepada saya

dalam proses penyusunan skripsi ini

6. Ibu Risa Herlianita, S.Kep., Ns., MSN selaku Penguji I yang telah

memberikan masukan dan saran dalam proses penyusunan skripsi ini

7. Bapak Zaqqi Ubaidillah, M.Kep, Sp.Kep.MB selaku Penguji II yang telah

memberikan masukan dan saran dalam proses penyusunan skripsi ini

vi

8. Kedua orang tua dan seluruh keluarga saya atas semua kasih sayang, do’a,

motivasi dan dukungan yang telah diberikan baik dukungan moril

maupun materi

9. Bidang Rekam Medik dan Instalasi Gawat Darurat Rumah Sakit TK II

Dr. Soepraoen Kota Malang yang telah memberikan pelayanan yang baik

kepada saya dalam menyelesaikan penelitian ini

10. Bidang Litbangkes Rumah Sakit TK II Dr. Soepraoen Kota Malang yang

telah memberikan pelayanan yang baik kepada saya dan membantu saya

dari awal studi pendahuluan hingga penyelesaian naskah skripsi ini.

11. Teman – teman PSIK C 2015, Keluarga FORISMA, Neurotransmitter,

KKN 16 UMM dan Teman – teman Kos 51 yang telah memberikan

bantuan dan dukungan kepada saya dalam menyelesaikan naskah skripsi

ini.

Serta semua pihak yang telah membantu penyelesaian skripsi ini. Mohon maaf

atas segala kesalahan dan ketidaksopanan yang mungkin telah saya perbuat. Semoga

Allah SWT senantiasa memudahkan setiap langkah – langkah kita menuju kebaikan

dan selalu menganugerahkan kasih sayang untuk kita semua. Aamiin

Malang, 26 September 2019

Penulis,

Chusnul Chatimah

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DAFTAR ISI

HALAMAN JUDUL ........................................................................................... i

LEMBAR PERSETUJUAN ............................................................................... ii

LEMBAR PENGESAHAN .............................................................................. iii

SURAT PERNYATAAN KEASLIAN PENULISAN ...................................... iv

KATA PENGANTAR ........................................................................................ v

DAFTAR ISI .................................................................................................... vii

DAFTAR TABEL.............................................................................................. xi

DAFTAR GAMBAR ......................................................................................... xii

DAFTAR LAMPIRAN .................................................................................... xiii

ABSTRAK ........................................................................................................ xiv

ABSTRACT ...................................................................................................... xv

BAB I PENDAHULUAN .................................................................................. 1

1.1 Latar Belakang ........................................................................................................ 1

1.2 Rumusan Masalah .................................................................................................. 6

1.3 Tujuan Penelitian .................................................................................................... 6

1.3.1 Tujuan Umum .............................................................................................. 6

1.3.2 Tujuan Khusus ............................................................................................. 6

1.4 Manfaat Penelitian .................................................................................................. 7

1.4.1 Manfaat Teoritis........................................................................................... 7

1.4.2 Manfaat Praktis ............................................................................................ 7

1.5 Keaslian Penulisan ................................................................................................. 8

BAB II TINJAUAN PUSTAKA ........................................................................ 16

2.1 Trauma and Injury Severity Score (TRISS) ...................................................... 16

2.1.1 Definisi Trauma and Injury Severity Score (TRISS) ............................ 16

2.1.2 Definsi Injury Severity Score (ISS) ............................................................... 17

2.1.3 Sistem Penilaian Anatomis ....................................................................... 18

2.1.4 Perhitungan Injury Severity Score (ISS) ....................................................... 19

2.1.5 Definisi Revised Trauma Score (RTS) ......................................................... 22

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2.1.6 Sistem Penilaian Fisiologis ....................................................................... 23

2.1.7 Perhitungan Revised Trauma Score (RTS) .................................................. 27

2.1.8 Tujuan Trauma and Injury Severity Score ............................................. 28

2.1.9 Manfaat Trauma and Injury Severity Score ........................................... 28

2.1.10 Perhitungan Trauma and Injury Severity Score (TRISS) ..................... 29

2.2 Prognosis ............................................................................................................... 31

2.2.1 Definisi Prognosis ..................................................................................... 31

2.2.2 Prognosis pada pasien trauma ................................................................. 32

2.2.3 Manfaat Prognosis ..................................................................................... 33

2.3 Cedera .................................................................................................................... 34

2.3.1 Definisi Cedera .......................................................................................... 34

2.3.2 Prevalensi Cedera ...................................................................................... 34

2.3.3 Penyebab Cedera ....................................................................................... 35

2.3.3.1 Proporsi Penyebab Cedera di Indonesia tahun 2013 ........... 37

2.3.3.2 Proporsi Penyebab Cedera menurut Karakteristik 2013 ..... 37

2.3.4 Proporsi Jenis Cedera ............................................................................... 38

2.3.4.1 Proporsi Jenis Cedera di Indonesia tahun 2013 .................... 39

2.3.4.2 Proporsi Jenis Cedera menurut Karakteristik tahun 2013 ... 40

2.3.5 Proporsi Tempat Terjadinya Cedera ....................................................... 41

2.3.5.1 Proporsi Tempat Terjadinya Cedera di Indonesia ................ 41

2.3.5.2 Proporsi Tempat Terjadinya Cedera menurut Karakteristik42

2.4 Sistem Penilaian TRISS dan mortalitas pasien trauma ................................... 44

BAB III KERANGKA KONSEP DAN HIPOTESIS PENELITIAN ............ 47

3.1 Kerangka Konsep ................................................................................................ 47

3.2 Hipotesis Penelitian ............................................................................................. 49

BAB IV METODOLOGI PENELITIAN ....................................................... 50

4.1 Desain Penelitian .................................................................................................. 50

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4.2 Kerangka Penelitian ............................................................................................. 51

4.3 Populasi, Sampel dan Sampling ......................................................................... 52

4.3.1 Populasi ....................................................................................................... 52

4.3.2 Sampel Penelitian....................................................................................... 52

4.3.2.1 Kriteria Inklusi ........................................................................... 53

4.3.2.2 Kriteria Eksklusi ........................................................................ 53

4.3.3 Sampling ..................................................................................................... 53

4.4 Variabel Penelitian ............................................................................................... 54

4.5 Definisi Operasional ............................................................................................ 55

4.6 Tempat Penelitian ................................................................................................ 56

4.7 Waktu Penelitian .................................................................................................. 56

4.8 Instrumen Penelitian ............................................................................................ 56

4.9 Prosedur Pengumpulan Data ............................................................................. 57

4.10 Analisa Data .......................................................................................................... 60

4.11 Etika Penelitian ..................................................................................................... 63

BAB V HASIL PENELITIAN DAN ANALISA DATA ................................. 65

5.1 Data Umum .......................................................................................................... 65

5.1.1 Proporsi Pasien Trauma berdasarkan Usia, Jenis Kelamin, Etiologi

dan Jenis Cedera di Rumah Sakit TK II Dr. Soepraoen Tahun 2018 .......... 65

5.2 Data Khusus ......................................................................................................... 66

5.2.1 Trauma and Injury Severity Score Pasien Trauma di Rumah Sakit TK II

Dr. Soepraoen Tahun 2018 ................................................................................ 66

5.2.2 Prognosis Pasien Trauma di Rumah Sakit TK II Dr. Soepraoen

Tahun 2018 ........................................................................................................... 67

5.2.3 Hubungan Trauma and Injury Severity Score dengan Prognosis Pasien

Trauma di Rumah Sakit TK II Dr. Soepraoen Tahun 2018 .......................... 67

BAB VI PEMBAHASAN ................................................................................. 69

6.1 Identifikasi Trauma and Injury Severity Score pada Pasien Trauma .................... 69

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6.2 Identifikasi Prognosis Pasien Trauma ............................................................... 73

6.3 Hubungan Antara Sistem Penilaian Trauma and Injury Severity Score dengan

Prognosis pada Pasien Trauma ...................................................................................... 74

6.4 Keterbatasan Penelitian ....................................................................................... 76

6.5 Implikasi Dalam Keperawatan ........................................................................... 76

BAB VII KESIMPULAN DAN SARAN ......................................................... 78

7.1 Kesimpulan ........................................................................................................... 78

7.2 Saran ....................................................................................................................... 79

DAFTAR PUSTAKA ......................................................................................... 81

Lampiran ................................................................................................................................ 88

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DAFTAR TABEL

Tabel 2.1 Sistem Penilaian ISS ........................................................................................... 18

Tabel 2.2 Hubungan nilai ISS dengan angka mortalitas ................................................. 21

Tabel 2.3 Skor Penilaian GCS............................................................................................. 23

Tabel 2.4 Tekanan Darah Normal Rata – Rata ................................................................ 25

Tabel 2.5 Kisaran Normal Frekuensi Pernapasan ........................................................... 26

Tabel 2.6 Revised Trauma Score (RTS) .................................................................................. 27

Tabel 2.7 Predicting Mortality with Revised Trauma Score (RTS) ........................................... 27

Tabel 2.8 Koefisien b0-b3 TRISS ...................................................................................... 29

Tabel 4.5 Definisi Operasional Korelasi Sistem Penilaian Trauma and Injury Severity

Score (TRISS) dan Prognosis Pasien Trauma .................................................................... 55

Tabel 4.10.1 Uji Hipotesis yang digunakan antar variabel TRISS dan prognosis ....... 62

Tabel 4.10.2 Interpretasi hasil uji hipotesis berdasarkan kekuatan korelasi, nilai p dan

arah korelasi .......................................................................................................................... 62

Tabel 5.1.1 Proporsi Pasien Trauma berdasarkan Usia, Jenis Kelamin, Etiologi dan

Jenis Cedera di Rumah Sakit TK II Dr. Soepraoen Tahun 2018 .................................. 65

Tabel 5.2.1 Hasil Trauma and Injury Severity Score Pasien Trauma di Rumah Sakit TK II

Dr. Soepraoen Tahun 2018................................................................................................. 66

Tabel 5.2.2 Distribusi Frekuensi Prognosis Pasien Trauma di Rumah Sakit TK II Dr.

Soepraoen Tahun 2018 ........................................................................................................ 67

Tabel 5.2.3 Analisis Hubungan antara Trauma and Injury Severity Score dengan

Prognosis Pasien Trauma di Rumah Sakit TK II Dr. Soepraoen Tahun 2018 ........... 68

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DAFTAR GAMBAR

Gambar 2.1 Calculator Injury Severity Score (ISS) ................................................................. 21

Gambar 2.2 Calculator Revised Trauma Score (RTS) ............................................................ 28

Gambar 2.3 Calculator Trauma and Injury Severity Score ...................................................... 31

Gambar 3.1 Korelasi Sistem Penilaian TRISS dan Prognosis Pasien Trauma di

Rumah Sakit TK II Dr. Soepraoen .................................................................................... 47

Gambar 4.2 Kerangka Penelitian Sistem Penilaian Trauma and Injury Severity Score

(TRISS) dan Prognosis Pasien Trauma di Rumah Sakit TK II Dr. Soepraoen Kota

Malang .................................................................................................................................... 51

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DAFTAR LAMPIRAN

Lampiran 1 Lembar ACC Judul Skripsi ............................................................................ 88

Lampiran 2 Surat Tugas Pembimbing ............................................................................... 89

Lampiran 3 Lembar Kesediaan Menjadi Pembimbing I ................................................ 90

Lampiran 4 Lembar Kesediaan Menjadi Pembimbing II ............................................... 91

Lampiran 5 Lembar Konsultasi Pembimbing I ............................................................... 92

Lampiran 6 Lembar Konsultasi Pembimbing II.............................................................. 94

Lampiran 7 Hasil Deteksi Plagiasi ..................................................................................... 96

Lampiran 8 Surat Ijin Studi Pendahuluan dan Penelitian ............................................... 98

Lampiran 9 Kode Etik Penelitian ...................................................................................... 99

Lampiran 10 Surat Pelaksanaan Penelitian ..................................................................... 100

Lampiran 11 Surat Keterangan Telah Selesai Melakukan Penelitian ......................... 101

Lampiran 12 Hasil Penelitian ............................................................................................ 102

Lampiran 13 Hasil Data Univariat .................................................................................... 147

Lampiran 14 Hasil Uji Bivariat .......................................................................................... 149

Lampiran 15 Dokumentasi Penelitian ............................................................................. 150

Lampiran 16 Curriculum Vitae ........................................................................................... 151

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