Perbandingan Skor KAsH dengan Skor Grace Saat Kontak Medis Pertama Sebagai Prediktor Kematian di Rumah Sakit pada Pasien Infark Miokard Akut di RSUP H. Adam Malik Medan

Abstract

Background. According to the World Health Organization, cardiovascular disease is the leading cause of death globally, with an estimated 17.9 million deaths in 2016 representing 31% of all global deaths, more than three-quarters of which occurred in low- and middle-income countries. The KAsH score maintains its predictive capacity after adjustment for several confounding factors such as diabetes, heart failure, mechanical complications and bleeding. So this study will try to see the ability of the KAsH score as a simple score. Aim. This study aims to show a comparison of KAsH and GRACE scores at the first medical contact as a predictor of in-hospital mortality in acute coronary syndrome patients at H Adam Malik General Hospital, Medan. Method. This study is an observational analytic study that aims to assess the comparison of the KAsH score and the GRACE score at the first medical contact as a predictor of in-hospital mortality in acute coronary syndrome patients at H Adam Malik Hospital, Medan. Observations of the sample were only carried out at one time without a follow-up period. Result. From the results of the study, it was found that living outcomes were 74.6% of subjects and 25.4% of subjects died. We found a relationship between diagnosis, ECG appearance, systolic blood pressure, diastolic blood pressure, pulse, and Killip's class with the incidence of mortality in IMA patients at H. Adam Malik Hospital, Medan. The KAsH score had a better ability than the GRACE score in predicting death during the first medical contact with an AUC value of 0.914 compared to an AUC value of 0.821. The KAsH score showed better sensitivity and specificity than the GRACE score in predicting death during the first medical contact with a sensitivity of 82.4% and a specificity of 90% compared to the GRACE score with a sensitivity of 76.5% and a specificity of 84%. KAsH scores have better LR+ and LR- scores than GRACE scores, namely LR+ 8.24 and LR – 0.195 compared to LR+ 4.78 and LR – 0.275 Conclusion. The KAsH score has a better ability than the GRACE score in predicting death during the first medical contact for AMI patients seeking treatment at H. Adam Malik Hospital.