EFFECT OF IMPLEMENTATION GUIDELINES PROCEDURES NEUTROPENI FEVER ON MORTALITY CANCER PATIENTS IN THE ISOLATION OF IMMUNITY DOWNHILL (RIIM) RS. CANCER DHARMAIS
ABSTRACT: Background : Febrile neutropenia can impact the high morbidity and mortality for cancer patients. The death rate in 2002 was 38.8% and in 2009 was decrease to 27.3%. The differences in mortality rates may be due to several factors such as the availability of Febrile Neutropeni Guidelines in 2006, in addition to human resources, equipment, and systems that may be better. Objectives : This study was conducted to determine the effect of the availability of this Guidelines to mortality of cancer patients in RIIM RSKD and other factors that influence such as compliance physicians, age, sex, degree of risk factors and the ability to pay of patients. Methods: This study is a cross sectional retrospective at the mortality of patients and compared with adherence to the Guidelines in the period 2008 - 2012. Data taken from patient medical record file than were analized with univariate and bivariate analysis. Results and Discussion : The death rate in 2008 to 2012 was 20,7%. The effect of age and sex on mortality was not significant (p 0.409 and p 0,404). Female patients and male died 25.5% and 17.2% respectivelly. Patients who paid by third party were higher than private (26,8% vs 10%), although not statistically significant (p 0.065). Mortality was found most on high-risk (22.3%). Compliance to diagram of flowchart treatment had a very significant effect on the incidence of death (15,5% vs 37% ; p 0,033). Conclusions and suggestions : The mortality rate of febrille neutropeni patient at RIIM RSKD in the periode 2008 to 2012 was 20,7%. The influence of age, sex and degree of the risk factors to mortality rate was not significantly different. Only one of which influence significantly to mortality (p 0.033) that is obedient to diagram. It's suggested that patients recording be better and completely. This guideline should be continued to be held and disseminated continuously.
