Penggunaan Skor Apfel Sebagai Prediktor Kejadian Mual dan Muntah Pascaoperasi di RSUP Dr. Hasan Sadikin Bandung

Abstract

Post-operative nausea and vomiting (PONV) is defined as any nausea, retching, or vomiting that occurs during the first 24 hour after surgery. Previous studies have reported that nationality and ethnicity influence the incidence of PONV. Apfel score is one of the objective and best simplified predicting PONV scoring systems available. Until recently, no predicting PONV score is used in Dr. Hasan Sadikin General Hospital (RSHS). Before implementing any scoring system as a protocol in this hospital, validation of the clinical risk assessment score in the hospital setu is needed. This was a cross-sectional diagnostic study on 100 patients underwentpost- various elective surgeries under general anesthesia. Subjects were divided into five groups, based on the Apfel risk scoring system. Factors observed consisted of four factors: female gender, nonsmoking status, post-operative use of opioids, and history of PONV or motion sickness. The results were analyzed for total incidence of PONV in each Apfel score group. Of 100 patients assessed, a total of 42% experienced PONV. Patients in Apfel score 0, 1, 2, 3, and 4 presented a PONV incidence score of 8.3%, 19.04%, 36.6%, 63.63%, and 80%, respectively. This incidence corresponds to the previous predicted values Apfel score. The incidence of PONV in patients under high risk Apfel score (≥3) was 61.9%, showing a significant correlation with PONV. The sensitivity was 61.9%, the specificity was 81.0%, and the AUC value was 0.777. This confirms that Apfel score has good validity to predict the incidence of PONV. In conclusion, Apfel scoring system is useful for identifying patients with PONV in RSHS.