Diana, Kinit (2013) Kadar Laktat Sebagai Prediktor Kematian Pada Pasien Cedera Kepala Sedang Dan Berat Di Rumah Sakit Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang. Cedera kepala merupakan penyebab kematian tertinggi yang berkaitan dengan trauma. Iskemik merupakan penyebab tunggal yang tersering yang berakibat kerusakan jaringan otak pada pasien cedera kepala dan menyebabkan metabolisme anaerob sehingga terjadi penumpukan laktat. Tujuan. Mengetahui hubungan dan resiko peningkatan kadar laktat darah pasien cedera kepala sedang dan berat pada pemeriksaan 1 jam dan 24 jam setelah masuk rumah sakit terhadap kematian. Serta mengetahui hubungan kadar laktat dengan skor GCS. Metode Penelitian. uji prognostik dengan desain kohort prospektif dengan mengamati kadar laktat pada 40 pasien cedera kepala sedang dan cedera kepala berat. Pemeriksaan kadar laktat dilakukan saat masuk rumah sakit (laktat I) dan setelah 24 jam (laktat II). Hasil. Hubungan kadar laktat I terhadap kematian dianalisis dengan uji korelasi Sperman didapatkan ada hubungan yang bermakna (p=0,007), r = 0.619. Titik potong 3,1 mmol/l, (64,7 % ;60,9 %) didapatkan odds ratio 1,543 CI 95% ( 0,405-5,879) dengan p=0,524. Kadar laktat II terhadap kematian, dengan uji korelasi spearman didapatkan hubungan yang bermakna (p = 0,00); r=0.838. Titik potong kadar laktat II 2,0 mmol/l, (94,1%; 69,6 %) didapatkan odds ratio 14,667 dengan CI 95% ( 1,659-129,701) , p=0,004. Hubungan kadar laktat dengan derajat GCS didapatkan p 0.05 (p=0.000), dengan koefisien korelasi sebesar r=-0.730. Kesimpulan. Terdapat hubungan yang bermakna antara kadar laktat I dan II terhadap kematian serta ada hubungan bermakna antara kadar laktat dan skor GCS pada pasien cedera kepala sedang dan berat.
English Abstract
Background. Head injury is leading cause of death associated with trauma. Ischemic is single most commom cause of brain damage that result in head injury pasients and lead to anaerobic metabolism resulting in accumulating of lactate. Purpose. Determine relationship and risk of an increase in blood lactate levels of patients of moderate and severe head injury performed on admission (lactate I) and after 24 hours (lactate II) to death. Determine relationship of blood lactate levels with GCS score. Methods.. Prognostic test with a prospective cohort design with lactate levels observed in 40 patients with moderate and severe head injury. Lactate levels performed on admission (lactate I) and after 24 hours (lactate II). Results. Relationship lactate levels with death was analyzed by Spearman correlation test found no significant relationship (p = 0.007), r = 0.619. Cut-off point 3.1 mmol / l, (64.7%, 60.9%) obtained odds ratio 1.543 95% CI (0.405 to 5.879) with p = 0.524. Relationship lactate levels with death, was analyzed by Spearman correlation test found a significant association (p = 0.00), r = 0.838. Cut off points lactate levels 2.0 mmol / l, (94.1%, 69.6%). obtained odds ratios with 95% CI 14.667 (1.659 to 129.701), p = 0.004. Relationship with score of GCS lactate levels obtained P 0.05 (p = 0.000), r = -0730. Conclusions. re was significant correlation between lactate I and II with death. re was significant correlation between lactate and GCS score in patients of moderate and severe head injury
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.849 1/DIA/k/041400172 |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.8 Diseases of nervous system and mental disorders |
| Divisions: | Profesi Kedokteran > Spesialis Patologi Klinik, Fakultas Kedokteran |
| Depositing User: | Budi Wahyono Wahyono |
| Date Deposited: | 13 May 2014 07:33 |
| Last Modified: | 13 May 2014 07:33 |
| URI: | http://repository.ub.ac.id/id/eprint/158434 |
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