Abstrak
Latar Belakang: Penyakit katup jantung merupakan beban katastropik kardiovaskular yang memerlukan manajemen efisiensi di faskes tersier. Lama rawat inap (Length of Stay/LOS) menjadi indikator krusial dalam menilai utilisasi tempat tidur dan efisiensi operasional. Penelitian ini bertujuan mendapatkan distribusi dan variasi lama rawat inap berdasarkan karakteristik pasien penyakit katup jantung di Rumah Sakit Universitas Indonesia. Metode: Studi kuantitatif potong-lintang (cross-sectional) dengan pendekatan sensus (total sampling) menggunakan data sekunder rekam medis periode Januari 2021–Desember 2024 di RSUI sebanyak 227 pasien.Variabel independen meliputi karakteristik klinis (jumlah katup terdampak, tingkat keparahan, LVEF, TAPSE, status gagal jantung) dan komorbiditas (hipertensi, PJK, jumlah komorbiditas lain). Analisis pola dilakukan secara deskriptif-komparatif melalui distribusi dan variasi pada populasi keseluruhan kemudian distratifikasi berdasarkan jenis kelamin dan usia. Hasil: Karakteristik pasien didominasi usia ≥50 tahun (79,7%), laki-laki (53,3%), dan gagal jantung (74,4%). Sebagian besar mengalami penurunan LVEF ≤50% (60,8%), disfungsi ventrikel kanan (TAPSE ≤16 mm; 27,8%), serta komorbiditas seperti penyakit ginjal kronis (36,1%) dan diabetes melitus (26,9%). Median lama rawat inap (LOS) adalah 5 hari (IQR 2 hari; rentang 2–18 hari). Hasil menunjukkan distribusi LOS relatif homogen pada populasi. Namun, analisis stratifikasi menemukan bahwa PJK memperpendek LOS pada laki-laki, sedangkan pada kelompok usia 60–69 tahun, tingkat keparahan katup berat, disfungsi ventrikel kanan, dan gagal jantung memperpanjang LOS. Kelompok usia >69 tahun memiliki LOS lebih singkat, mencerminkan pendekatan terapi yang lebih konservatif. Kesimpulan: Lama rawat inap pasien VHD di RSUI relatif homogen dengan median 5 hari, menunjukkan efektivitas standardisasi clinical pathway dalam mengurangi variasi pelayanan. RSUI disarankan menerapkan stratifikasi risiko sejak admisi dengan memperhatikan fungsi ventrikel kanan (TAPSE) dan komorbiditas utama, terutama pada pasien pralansia dan lansia awal.
Background: Valvular heart disease (VHD) represents a major cardiovascular burden that requires efficient management in tertiary healthcare facilities. Length of stay (LOS) is a key indicator for assessing bed utilization and operational efficiency. This study aimed to describe the distribution and variation in LOS according to the characteristics of patients with valvular heart disease at the University of Indonesia Hospital (RSUI). Methods: This quantitative cross-sectional study employed a census (total sampling) approach using secondary medical record data from 227 patients treated at the University of Indonesia Hospital (RSUI) between January 2021 and December 2024. The independent variables included clinical characteristics (number of affected valves, disease severity, LVEF, TAPSE, and heart failure status) and comorbidities (hypertension, coronary artery disease, and the number of other comorbidities). Pattern analysis was conducted using descriptive-comparative methods by examining the distribution and variation of length of stay in the overall study population, followed by stratification according to sex and age. Results: The majority of patients were aged ≥50 years (79.7%), male (53.3%), and had heart failure (74.4%). Most patients had reduced left ventricular ejection fraction (LVEF ≤50%; 60.8%), right ventricular dysfunction (TAPSE ≤16 mm; 27.8%), and comorbidities such as chronic kidney disease (36.1%) and diabetes mellitus (26.9%). The median length of stay (LOS) was 5 days (IQR: 2 days; range: 2–18 days). Overall, LOS was relatively homogeneous across the study population. However, stratified analysis showed that coronary artery disease (CAD) was associated with a shorter LOS among male patients, whereas in the 60–69-year age group, severe valvular disease, right ventricular dysfunction, and heart failure were associated with a longer LOS. Patients aged >69 years had a shorter LOS, reflecting a more conservative therapeutic approach. Conclusion: The LOS of patients with VHD at RSUI was relatively homogeneous, with a median of 5 days, suggesting that standardized clinical pathways effectively reduced variations in healthcare delivery. RSUI is recommended to implement risk stratification upon admission by considering right ventricular function (TAPSE) and major comorbidities, particularly among pre-elderly and early elderly patients.