Analisis Survival Acute Myeloid Leukemia (AML) Di Rumah Sakit Universitas Airlangga Dengan Model Regresi Cox PH

Mulyana, Luthfia (2026) Analisis Survival Acute Myeloid Leukemia (AML) Di Rumah Sakit Universitas Airlangga Dengan Model Regresi Cox PH. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Acute Myeloid Leukemia (AML) merupakan salah satu subtipe leukemia yang membutuhkan pemantauan ketat terhadap perkembangan penyakit dan risiko kematian pasien. Penelitian ini bertujuan untuk mengidentifikasi karakteristik survival pasien Leukemia tipe AML serta mengidentifikasi faktor-faktor yang berpengaruh signifikan terhadap waktu survival pasien menggunakan model Regresi Cox Proportional Hazard (Cox PH). Data yang digunakan merupakan data rekam medis pasien AML di Rumah Sakit Universitas Airlangga periode Januari 2023 hingga Desember 2025 sebanyak 27 pasien, dengan variabel prediktor meliputi jenis kelamin, usia, kadar hemoglobin, jumlah leukosit, kadar hematokrit, jumlah trombosit, dan status kemoterapi. Karakteristik survival dianalisis menggunakan statistika deskriptif, kurva Kaplan-Meier, dan uji Log-rank, sedangkan pemodelan dilakukan melalui estimasi parameter, eliminasi backward, uji asumsi proportional hazard, dan interpretasi hazard ratio. Hasil analisis deskriptif menunjukkan bahwa pasien datang dengan kondisi klinis yang cukup berat, ditandai dengan kadar hemoglobin dan hematokrit yang jauh di bawah normal serta jumlah leukosit dan variasi trombosit yang ekstrem, dengan 74% pasien mengalami kematian selama periode pengamatan. Probabilitas bertahan hidup pasien menurun tajam pada awal periode pengamatan dan melandai pada periode selanjutnya, dengan jumlah trombosit dan status kemoterapi menunjukkan perbedaan distribusi survival yang signifikan antar kelompok (p-value < 0,05). Model Cox PH terbaik yang diperoleh melalui eliminasi backward terdiri atas variabel jenis kelamin, kadar hemoglobin, dan kemoterapi, yang secara simultan signifikan dan memenuhi asumsi proportional hazard. Secara parsial, kemoterapi berpengaruh signifikan terhadap hazard pada taraf 5% dengan nilai Hazard Ratio sebesar 0,028 yang menunjukkan bahwa kemoterapi berperan sebagai faktor protektif yang menurunkan risiko kematian pasien AML secara signifikan, sedangkan jenis kelamin dan kadar hemoglobin baru berpengaruh signifikan pada taraf 10%. Hasil ini menegaskan bahwa status kemoterapi merupakan faktor penentu paling kuat terhadap kelangsungan hidup pasien AML di RSUA, melampaui pengaruh karakteristik demografis dan hematologis awal pasien.
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Acute Myeloid Leukemia (AML) is a subtype of leukemia that requires close monitoring of disease progression and patient mortality risk. This study aims to identify the survival characteristics of AML-type Leukemia patients and identify factors that significantly influence patient survival time using the Cox Proportional Hazard (Cox PH) Regression model. The data used are medical records of 27 AML patients at Airlangga University Hospital from January 2023 to December 2025, with predictor variables including gender, age, hemoglobin level, leukocyte count, hematocrit level, platelet count, and chemotherapy status. Survival characteristics were analyzed using descriptive statistics, Kaplan-Meier curves, and the Log-rank test, while modeling was carried out through parameter estimation, backward elimination, proportional hazard assumption tests, and hazard ratio interpretation. The results of the descriptive analysis showed that patients came with quite severe clinical conditions, characterized by hemoglobin and hematocrit levels far below normal as well as extreme leukocyte counts and platelet variations, with 74% of patients experiencing death during the observation period. The probability of patient survival decreased sharply at the beginning of the observation period and leveled off later in the period, with platelet count and chemotherapy status showing significant differences in survival distribution between groups (p-value <0.05). The best Cox PH model obtained through backward elimination consisted of the variables sex, hemoglobin level, and chemotherapy, which were simultaneously significant and met the proportional hazard assumption. Partially, chemotherapy had a significant effect on the hazard at the 5% level with a Hazard Ratio value of 0.028, indicating that chemotherapy acted as a protective factor that significantly reduced the risk of death in AML patients, while sex and hemoglobin level only had a significant effect at the 10% level. These results confirm that chemotherapy status is the strongest determinant of survival in AML patients at RSUA, surpassing the influence of the patient's initial demographic and hematological characteristics.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	Analisis Kelangsungan Hidup, Corrected Akaike Information Criterion, Hazard Ratio, Leukimia, Model Cox Proporsional Hazard, Proportional Hazards Model, Survival Analysis
Subjects:	Q Science > QA Mathematics > QA276 Mathematical statistics. Time-series analysis. Failure time data analysis. Survival analysis (Biometry)
Divisions:	Faculty of Science and Data Analytics (SCIENTICS) > Statistics > 49201-(S1) Undergraduate Thesis
Depositing User:	Luthfia Fairuz Mulyana
Date Deposited:	05 Aug 2026 02:35
Last Modified:	05 Aug 2026 02:35
URI:	http://repository.its.ac.id/id/eprint/143813

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