Professional Documents
Culture Documents
DokterRs YUS
DokterRs YUS
Sumber Informasi
1. Medical Record (kematian di faskes)
2. Autopsi Verbal (kematian di rumah/di luar faskes)
TAHAPAN PENYEDIAAN STATISTIK PENYEBAB KEMATIAN
Di rumah
b) Cardiomyopathy
Due to (or as a consequence of)
c) Amyloidosis
Due to (or as a consequence of)
d) -
Bagian I lanjutan
Contoh:
• Pasien dengan kanker meninggal dan penyebab
terakhirnya adalah gagal jantung yang disebabkan
oleh adanya carcinomatosis. Neoplasma
primernya terdapat pada usus (colon). Sekuensi
dari neoplasma colon ini adalah menghasilkan
carcinomatosis kemudian menyebabkan gagal
jantung. Sehingga penyebab dasarnya (underlying
cause of death)adalah kanker usus/ca. colon.
Diagnostik dalam MCCD
a) Heart failure
b) Carcinomatosis
Due to (or as a consequence of)
d) -
Bagaimana Jika Diperkirakan Terdapat Lebih
Dari Satu Penyakit/Kondisi Penyebab Kematian?
• Gunakan konsep URUTAN LOGIKA secara medis
• Kondisi/penyakit yang diisi pada baris terbawah di bagian I adalah kondisi
yang dapat menimbulkan seluruh rangkaian kondisi yang diisi di atasnya
• Ia. Gagal hati
• Ib. Obstruksi saluran empedu
• Ic. Carcinoma pancreas
• Id. –
• Urutan logika: Ca pancreas menyebabkan obstruksi saluran empedu dan
akhirnya menyebabkan kegagalan hati
• Lama waktu mulai sakit sampai dengan meninggal membantu memberikan
petunjuk pilihan penyebab dasar, antara dan penyebab langsung kematian
Bagian II
Cause of Death Approximate interval
between onset and death
I a)
Disease or condition directly leading to death*
Due to (or as a consequence of)
b)
d) -
II.
Other significant
conditions contributing
to the death, but not
related to the disease
or condition causing it
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It means the disease, injury, or complication that
caused death.
Bagian II (lanjutan)
I Duration between
Disease or condition (a)… Acute on chronic renal failure onset and death
directly leading to due to or as a consequence of …12 hari…
death*
Antecedent causes (b)… Glomerulonephritis….. …1 tahun
Morbid conditions due to or as a consequence of
giving rise to the above
…5 tahun
cause, stating the underlying (c)…. Diabetic nephropathy…
condition last due to or as a consequence of
…10 tahun…
(d)… Diabetes Type II…
II
Other significant conditions Femoral neck fracture, femoral 1 bulan
contributing to the death, fracture repair, ………………………
…………………
but not related to the disease Post operative haematoma
condition causing it ………………………………
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It means the
disease, injury or complication that caused death.
Sertifikasi Medis Penyebab Kematian lengkap
I Duration between
Disease or condition (a)… Meningitis onset and death
directly leading to due to or as a consequence of …12 hari…
death*
Antecedent causes (b)… Tuberculosis of Lung….. …5 bulan
Morbid conditions due to or as a consequence of
giving rise to the above
cause, stating the underlying (c)…………………………………. ……………
condition last due to or as a consequence of
II
Other significant conditions Diabetes Type II 5 tahun
contributing to the death, Hepatitis akut 2 bulan ……
but not related to the disease
condition causing it ………………………………
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It means the
disease, injury or complication that caused death.
Contoh 1
I Duration
Disease or condition (a)…Perdarahan massif gastro between onset
and death
intestina ……
directly leading to due to or as a consequence of
death*
…
Antecedent causes (b)…Pecah varices oesophagus
Morbid conditions due to or as a consequence of …
giving rise to the above
cause, stating the underlying (c)…. Cirrhosis hepatis
condition last due to or as a consequence of ……
I Duration
Disease or condition (a)…Bronchopneumonia between
karena aspirasi onset and
death
……
directly leading to due to or as a consequence of
death* …
Antecedent causes (b)…Coma yang lama
Morbid conditions due to or as a consequence of …
giving rise to the above
cause, stating the underlying (c)…. Infark cerebrovascular
condition last due to or as a consequence of ……
(d)…
II
Other significant conditions
contributing to the death, ………………
but not related to the disease …………
condition causing it
*This does not mean the mode of dying e.g. heart failure,
respiratory failure. It means the disease, injury or complication that
caused death.
Contoh 3
I Duration
Disease or condition (a)…Emboli paru between
directly leading to due to or as a consequence of onset and
death* death
Antecedent causes (b)…fraktur tulang femur ……
patologis …
Morbid conditions due to or as a consequence of
giving rise to the above …
cause, stating the underlying (c)…. Karsinoma sekunder
pada femur
condition last due to or as a consequence of ……
(d)…Karsinoma Payudara
II
Other significant conditions
contributing to the death, ………………
but not related to the disease …………
condition causing it
*This does not mean the mode of dying e.g. heart failure,
respiratory failure. It means the disease, injury or complication that
caused death.
Contoh 4
I Duration between
onset and death
Disease or condition (a)…Acute respiratory distress 2 hari…
syndrome
directly leading to due to or as a consequence of
death*
Antecedent causes (b)…Pneumonia 10 hari…
(d)
II
Other significant conditions DM type 2 14 tahun…
contributing to the death,
but not related to the disease COPD 8 tahun
condition causing it
*This does not mean the mode of dying e.g. heart failure, respiratory failure.
It means the disease, injury or complication that caused death.
Contoh 5
I Duration between
onset and death
Disease or condition (a)…Respiratory failure 2 hari…
directly leading to due to or as a consequence of
death*
Antecedent causes (b)…Pneumonia 8 hari…
(d)
II
Other significant conditions
contributing to the death,
I Duration between
onset and death
Disease or condition (a)…Traumatik shock
(d)
II
Other significant conditions
contributing to the death,
but not related to the disease
condition causing it
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It means the
disease, injury or complication that caused death.
Hal-hal yang harus dihindari di dalam penulisan
cause of death
Mekanisme kematian (mode of dying)
Asphyxia Debility (kelemahan) Kidney Failure (gagal
ginjal)
Asthenia Exhaustion Liver Failure (gagal
(kelelahan) hati)
Ill defined yang sering ditemukan sebagai cause of
death
Kecelakaan/Accident • Jelaskan kronologis kejadiannya
• Jenis kendaraannya?, kecelakaan
murni atau dicelakakan orang lain,
atau bunuh diri.
• Jelaskan dimana tempat kejadiannya
Kode ICD-10
B95-B97 Bacterial, viral and other infectious
agents
G97,H95, N99 Post procedural disorders (Note the
cross reference to Section 4.2.6
“Operations” in volume 2)
O80 - O84 Method of delivery
S00 - T98 Injury, poisoning and certain other
consequences of external causes
Latihan 1
I Duration between
Disease or condition (a)… Peritonitis onset and death
directly leading to due to or as a consequence of …1 hari…
death*
Antecedent causes (b)… Duodenal Perforation….. …2 hari
Morbid conditions due to or as a consequence of
giving rise to the above
…5 tahun
cause, stating the underlying (c)…. Chronic duodenal ulcer…
condition last due to or as a consequence of
………..…
(d -
II
Other significant conditions
contributing to the death, ……………………
but not related to the disease ……………………
condition causing it ………………………………
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It
means the disease, injury or complication that caused death.
II
Other significant conditions
contributing to the death, ……………………
but not related to the disease ……………………
condition causing it ………………………………
*This does not mean the mode of dying e.g. heart failure, respiratory failure. It
means the disease, injury or complication that caused death.
Hyperglycemia coma
Contoh Resume Kasus
Kasus 1
Perempuan, 37 tahun
Masuk ke dalam IGD dengan edema generalisata,
sesak nafas dan ascites
Tekanan darah 150 / 100, peningkatan denyut nadi 80
kali per minute,
Liver teraba 5 jari dibawah costal
Sudah beberapa tahun mendapatkan terapi chronic
glomerulonephritis
Dengan pengobatan, ada perbaikan sedikit, dengan
tekanan darah turun naik antara 150-180 / 100-120
Setelah 1 bulan kondisi kesehatan semakin menurun,
berbaring selama 1 minggu kemudian terjadi acute
pulmonary oedema
Medical certification
salah benar
c) Artherosklerosis tahunan
d) -
II -
Contoh resume 4
d)-
II Chronic rheumatic heart disease tahunan
hypertension
Contoh resume 5
Due to C
Respiratory distress
syndrome
Due to D
Other significant conditions contributing to death Ectopic pregnancy, lady was giving birth
Maternal death
Time interval
Cause of death from onset to
death
Disease or condition
directly leading to
death
Immediat
e A Severe Burns
Report chain of
events in “due to”
order (B-D) if Due to B
applicable
State the underlying
cause on the lowest
used line
Due to C
Due to D
Underlying
Time interval
Cause of death from onset to
death
Disease or condition
directly leading to death
Immediate A
Cardiopulmonary
arrest
Report chain of events in
“due to” order (B-D) if
applicable Due to B AMI
State the underlying cause
on the lowest used line
Due to C HT
Due to D
Underlying
Time interval
Cause of death from onset to
death
Disease or condition
directly leading to death
Immediate A Stroke/anaemia
Due to C
Due to D
Ilustrasi 1
• Seorang wanita berumur 45 tahun yang baru melakukan perjalanan ke
luar negeri, masuk ke rumah sakit dengan Riwayat demam dan
tenggorakan sakit selama 3 hari.
• Kemudian dilakukan nasopharyngeal swab dan hasilnya positi Covid-19.
• Pasien mengalami perburukan sulit bernafas dan di diagnose
Pneumonia.
• Pada hari ke lima perawatan, pasien mengalami respiratory distress
yang berat dan kemudian meninggal.
• Pasien mempunyau penyakit diabetes type 2 sudah 15 tahun dan
hypertensi sudah 10 tahun
Completed Medical Certificate of Cause of Death
I Duration
Disease or condition (a)… Severe acute respiratory between
onset and
distress death
syndrome …1 hari…
directly leading to due to or as a consequence of
death*
Antecedent causes (b)…Covid 19 Infeksi Pneumonia…..
…5 hari
Morbid conditions due to or as a consequence of
giving rise to the above
cause, stating the underlying (c)….Covid 19 laboratory
confirmed …8 hari
condition last due to or as a consequence of
(d)…… ……
II
Other significant conditions Diabetes Type II… 15 tahun…
contributing to the death, Hypertention
but not related to the disease 10 tahun
condition causing it ………………………………
*This does not mean the mode of dying e.g. heart failure, respiratory
failure. It means the disease, injury or complication that caused death.
Ilustrasi 3
•Laki-laki umur 60 tahun masuk rumah sakit dengan Riwayat demam 5 selama 5
hari, tenggorokan sakit dan nyeri otot. Ia meriwayatkan rasa tidak enak di dada
sejak 2 tahun yang lalu, hypertensi, dan perokok berat 1 pack per hari, dan
Riwayat diabetes melitus sejak 10 tahun yang lalu. Pasien dikategorikan obesitas
dan hypercholesterolemia berat. Hasil nasopharyngeal swab untuk PCR positip
yang dilakukan pada saat masuk rumah sakit. Setelah 3 hari di rawat di rumah
sakit , demam dan nyeri tenggorokannya sudah mereda. Pada hari ke sepuluh
dirawat, PCR ke dua hasilnya negative. Satu hari kemudian, pasien mengeluh
nyeri dada sampai ke belakang dada dengan tiba-tiba bersamaan keringat
dingin, mual dan muntah. Hasil ECG memperlihatkan non-ST elevation anterior
myocardial infarction. Dilakukan catheterisation cardiac pada hari berikutnya,
dan diketahui multi-vessel coronary artery stenosis berat. Dua jam setelah
cardiac catheterisation, ia Kembali mengalami nyeri dada hebat dan mengarah
ke cardiac arrest. Dilakukan resuscitation,pasien meninggla setelah 30 menit dari
henti jantung.
Completed Medical Certificate of Cause of Death
I Duration
Disease or condition (a)… Myocard infarction between
onset and
directly leading to due to or as a
death
consequence of
death* …2 hari…
Antecedent causes (b)…coronary arteriosclerosis…..
Morbid conditions due to or as a consequence of …2 tahun
giving rise to the above
cause, stating the underlying (c)…………………………………..
…
condition last due to or as a consequence of
……
(d)……
II
Other significant conditions Covid 19 (test positip 17 ahri) Diabetes
Type II (10 tahun), Hypertention (10,
contributing to the death, merokok (30 tahun),
but not related to the disease obesitas, hypercholesterolmia
condition causing it
*This does not mean the mode of dying e.g. heart failure, respiratory
failure. It means the disease, injury or complication that caused death.
Lembar 1
Lembar 2
Lembar 3
Lembar 1
perinatal
/ iufd
Lembar 2
dan 3
perinatal /
iufd
Kesimpulan
Registrasi sipil dapat menjadi sumber statistik vital yang dapat dipercaya
Statistik vital yang terpercaya digunakan untuk dasar perencanaan
diberbagai bidang yang efektif dan efisien
Peran bidang kesehatan untuk Registrasi Sipil dan Statistik Vital sangat
penting (kelahiran, kematian dan penyebab kematian)
Statistik vital dapat dihasilkan dengan koordinasi lintas sektoral
Undang undang kependudukan no 23 tahun 2006 dan perubahannya no
24 tahun 2013 telah mengatur Registrasi sipil.
Peran dokter dan medical record akan meningkatkan mutu
pencatatan penyebab kematian di rumah sakit
Perlu peningkatan sistem di tingkat kabupaten/kota sebagai cikal bakal
untuk tingkat nasional.
Terima
Kasih
Dr. Yuslely usman M.ke;s; lelyus@yahoo.com