Hubungan Kadar hs-CRP dengan Keluaran Klinis Berdasarkan Indeks Barthel pada Pasien Stroke Iskemia Akut

Diana* dan Mohammad Saiful Ardhi**
* Peserta Program Pendidikan Dokter Spesialis I Neurologi Fakultas Kedokteran Universitas Airlangga/RSUD Dr. Soetomo Surabaya
** Staf pengajar SMF/Departemen Neurologi Fakultas Kedokteran Universitas Airlangga/RSUD Dr. Soetomo Surabaya

Abstract

Pendahuluan: Kerusakan jaringan otak akibat iskemia menyebabkan inflamasi lokal akut dan perubahan sitokin inflamasi terutama C- reactive protein (CRP). Tujuan: Penelitian ini untuk membuktikan hubungan antara kadar hs-CRP dengan keluaran klinis yang dinilai dengan menggunakan indeks Barthel pada pasien stroke iskemia akut. Metode: Penelitian ini merupakan penelitian analitik observasional dengan rancangan penelitian kohort pada pasien stroke iskemia akut yang memenuhi kriteria inklusi dan eksklusi. Pada subjek penelitian dilakukan pemeriksaan kadar hs-CRP saat awitan stroke iskemia < 72 jam dan dilakukan pemeriksaan keluaran klinis dengan menggunakan indeks Barthel saat tujuh hari awitan stroke iskemia. Hasil: Analisis penelitian menunjukkan bahwa subjek penelitian yang memiliki kadar hs-CRP ≥ 1,5 mg/dL dengan indeks Barthel <75 yaitu 7 subjek (63,6%) lebih besar dibandingkan pada indeks Barthel ≥ 75 yaitu 4 subjek (36,4%), perbedaan ini bermakna secara statistik dengan p= 0,00, RR=3,118 (IK 95%, 1,532-6,348). Usia ≥ 60 tahun dengan indeks Barthel < 75 yaitu 12 subjek (42,9%) dan indeks Barthel ≥ 75 sebanyak 16 subjek (57,1%), p=0,020, RR= 2,743 (IK 95% 1,102-6,826). Analisis multivariat menunjukkan adjusted OR 6,159 (p=0,016) pada kadar hs-CRP ≥ 1,5 mg/dL dan adjusted OR 3,666
(p=0,048) pada usia ≥ 60 tahun. Kesimpulan: Terdapat hubungan yang bermakna antara kadar hs-CRP dengan keluaran klinis yang dinilai dengan menggunakan indeks Barthel pada pasien stroke iskemia akut.

Kata Kunci: High Sensitivity C-Reactive Protein, Indeks Barthel, Stroke Iskemia

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