Perbandingan Glasgow Coma Scale dan Gambaran Midline-Shift CT-Scan Kepala sebagai Prediktor Mortalitas Pasien Cedera Kepala
DOI:
https://doi.org/10.55175/cdk.v45i4.796Kata Kunci:
Cedera kepala, glasgow coma scale, midline-shift, prediktor mortalitasAbstrak
Pendahuluan: Cedera kepala merupakan satu penyebab utama kematian dan disabilitas di dunia terutama pada usia produktif. Prediksi awal keluaran pasien cedera kepala yang akurat penting untuk menentukan keputusan klinis, alokasi rasional sumber daya, dan konseling keluarga. Penelitian ini bertujuan untuk membandingkan Glasgow Coma Scale (GCS) dengan Midline-Shift (MLS) sebagai prediktor mortalitas pasien cedera kepala. Metode: Penelitian analitik potong-lintang pada 43 pasien. Data GCS dan status pasien saat masuk IGD diambil dari rekam medis RSUD Dr. Abdul Aziz Kota Singkawang dan data MLS diketahui melalui hasil CT-scan di RS Santo Vincentius Kota Singkawang. Analisis data menggunakan uji korelasi Spearman dan dilakukan perbandingan antara GCS dan MLS terhadap status keluar pasien. Hasil: Nilai GCS memiliki hubungan moderat terhadap status keluar pasien (IK 95%; p = 0,018; r = 0,361). MLS memiliki hubungan kuat terhadap status keluar pasien (IK 95%; p = 0,000; r = 0,531). Makin rendah nilai GCS dan makin tinggi nilai MLS, makin banyak status keluar meninggal. Simpulan: MLS memiliki korelasi lebih kuat sebagai prediktor mortalitas daripada GCS pada pasien cedera kepala.
Introduction: Head injury is one of the main causes of death and disability in productive ages. Early and accurate outcome prediction is very important to aid clinical decision, rational allocation of resources and family counseling. The purpose of this study is to compare Glasgow Coma Scale (GCS) and Midline-Shift (MLS) as the predictor of head injury patients’ mortality. Methods: An analytical cross-sectional study was performed on 43 patients. GCS and patient’s data were obtained from RSUD Dr. Abdul Aziz Singkawang medical records and MLS data were obtained from CT-Scan data, done in RS Santo Vincentius Singkawang. The correlation of GCS and MLS to patients’ outcome was analyzed by Spearman correlation test. Results: GCS had moderate correlation to patients’ outcome (CI 95%; p = 0,018; r = 0,361). MLS had strong correlation to patients’ outcome (CI 95%; p = 0,000; r = 0,531). Lower GCS value and higher MLS correlate to higher mortality. Conclusion: MLS had stronger correlation than GCS to mortality of head injury patients.
Unduhan
Referensi
Sadaka F, Patel D, Lakshmanan R. The FOUR score predicts outcome in patients after traumatic brain injury. Neurocrit Care. 2012;16(2012):95-101.
Abelson-Mitchell N. Neurotrauma: Managing patients with head injury. Oxford: John Wiley & Sons; 2013.
Riyadina W, Suhardi, Permana M. Pola dan determinan sosiodemografi cedera akibat kecelakaan lalu lintas di Indonesia. Maj Ked Indon. 2009;59(10):464-72.
Badan Pusat Statistik Provinsi Kalimantan Barat. Kalimantan Barat dalam angka 2015. Pontianak: BPS-Provinsi Kalimantan Barat; 2015.
Kepolisian Resort Kota Singkawang. Data penyelesaian perkara Laka Lantas tahun 2012-2015. Singkawang: Kepolisian Negara Republik Indonesia Daerah Kalimantan Barat Resort Singkawang; 2015.
World Health Organization. Traumatic brain injuries. In: Neurological disorders: public health challenges. Geneva: World Health Organization; 2006.
Mata-Mbemba D, Mugikura S, Nakagawa A, Murata T, Ishii K, Takase K, et al. Early CT findings to predict early death in patients with traumatic brain injury: Marshall and Rotterdam CT scoring systems compared in major academic tertiary care hospital in northeastern Japan. Acad Radiol. 2014;21(5):605-11.
Nirula R, Maier R, Moore E, Sperry J, Gentilello L. Scoop and run to the trauma center or stay and play at the local hospital: Hospital transfer’s effect on mortality. J Trauma. 2010;69(3):595-601.
Munakomi S. A comparative study between Marshall and Rotterdam CT scores in predicting early deaths in patients with traumatic brain injury in a major tertiary care hospital in Nepal. Chinese J Trauma 2016;19(2016): 25-7.
Ting HW, Chen MS, Hsieh YC, Chan CL. Good mortality prediction by glasgow coma scale for neurosurgical patients. J Chin Med Assoc. 2010;73(3):139-43.
Chiewvit P, Tritakarn S, Nanta-aree S, Suthipongchai S. Degree of midline shift from CT scan predicted outcome in patients with head injuries. J Med Assoc Thai 2010;93(1):99-107.
Kumar R, Mahapatra AK. A Textbook of head injury. 1st ed. New Delhi: JP Medical Ltd; 2012.
Alqarni M, Arabi Y, Kakiashvili T, Khedr M, Koczkodaj W, Leszek J, editors. Improving the predictability of ICU illness severity scales. Proceedings of the federated conference on computer science and information systems; 2011 .p. 11-7.
Snell RS. Clinical neuroanatomy. 7th ed. Philadelphia: Wolters Kluwer; 2010.
Takahashi C, Hinson H, Bagulay IJ. Autonomic dysfunction syndromes after acute brain injury. 3rd ed. Philadelphia: Elsevier; 2015.
Igbaseimokumo U. Brain CT scans in clinical practice. London: Springer; 2009.
Jalali R, Rezaei M. A comparison of the glasgow coma scale score with full outline of unresponsiveness scale to predict patients’ traumatic brain injury outcomes in intensive care units. Crit Care Res Pract. 2014;2014:1-4.
American College of Surgeons. Advanced trauma life support: Student course manual. 9th ed. Chicago: American College of Surgeons; 2012.
Silverthorn DU. Human physiology: An integrated approach. 6th ed. Boston: Pearson; 2013.
Johns P. Clinical neuroscience. London: Elsevier; 2014.
Unduhan
Diterbitkan
Cara Mengutip
Terbitan
Bagian
Lisensi
Hak Cipta (c) 2018 https://creativecommons.org/licenses/by-nc/4.0/
Artikel ini berlisensi Creative Commons Attribution-NonCommercial 4.0 International License.