Hubungan Diagnosis Klinis Dengan Uji Kualitas Metanol Serum Dan Hubungan Pemeriksaan Laboratorium Tidak Langsung Dengan Kadar Metanol Serum Pada Pasien Intoksikasi Metanol

Rintawan, Corona and dr. Ari Prasetyadjati,, Sp.Em and dr. Ali Haedar, Sp.Em, Sp.Em and dr. Harun Al Rasyid,, MPH (2018) Hubungan Diagnosis Klinis Dengan Uji Kualitas Metanol Serum Dan Hubungan Pemeriksaan Laboratorium Tidak Langsung Dengan Kadar Metanol Serum Pada Pasien Intoksikasi Metanol. Magister thesis, Universitas Brawijaya.

Abstract

Pendahuluan: Di seluruh dunia, kasus keracunan metanol masih sering terjadi, terutama di negara-negara yang melarang penjualan alkohol secara bebas. Tingkat kematian akibat keracunan metanol sangat tinggi. Diagnosis yang cepat dan tepat masih menjadi tantangan karena diperlukan pemeriksaan laboratorium khusus untuk mendeteksi keberadaan metanol dalam darah. Dokter umum sering hanya mengandalkan diagnosis klinis dan pemeriksaan laboratorium sederhana untuk membantu mendiagnosis keracunan metanol. Penelitian ini bertujuan untuk mengetahui hubungan antara diagnosis klinis dengan kadar metanol serum kualitatif dan hubungan antara pemeriksaan laboratorium tidak langsung (pH, anion gap, laktat dan osmolalitas darah) dengan kadar kuantitatif metanol serum pada pasien intoksikasi metanol.Desain Penelitian: Desain penelitian yang digunakan adalah observasional analitik dengan pendekatan cross sectional. Subyek penelitian adalah pasien dengan diagnosa suspek keracunan metanol di RSUD dr. Saiful Anwar, Malang, Jawa Timur selama periode Juli 2016 sampai Juli 2018. Lokasi penelitian di RSU Dr. Saiful Anwar, Malang, Jawa Timur; dan laboratorium forensik Polda Jawa Timur, Surabaya. Data dicatat dalam register khusus yang kemudian dilakukan uji korelasi Spearman untuk menguji korelasi antara hasil laboratorium tidak langsung (pH, anion gap, laktat dan osmolalitas) dengan kadar Methanol kuantitatif. Uji Fisher Exact dan uji Chi square digunakan untuk menguji hubungan antara diagnosis klinis dan uji kualitatif metanol serum. Program analisis yang digunakan adalah SPSS 20 Hasil: Total 32 kasus suspek intoksikasi metanol, 3 kasus dalam kriteria eksklusi. Dari 29 kasus, lebih banyak terjadi pada pria (83%) dibandingkan wanita dengan usia rata-rata 28,75 tahun. Hasil uji Fisher's Exact pada p = 0,692 atau lebih besar dari = 0,05, sehingga dinyatakan tidak ada perbedaan yang bermakna antara diagnosis klinis dengan kadar metanol serum secara kualitatif. Dari uji diagnostik, diagnosis klinis memiliki nilai sensitivitas 86,4% dan nilai prediksi positif 76% tetapi nilai spesifisitasnya hanya 14,3% dan nilai prediksi negatif hanya 25%. Uji korelasi Spearman menunjukkan bahwa ada hubungan yang signifikan antara kadar metanol serum dengan pH (p = <0,01), laktat (p = 0,012), anion gap (p = <0,01) dan osmolalitas (p = 0,012). Kesimpulan: Tidak ada hubungan yang bermakna antara diagnosis klinis dengan kadar metanol serum kualitatif. Ada hubungan yang bermakna antara pH, laktat, anion gap dan osmolalitas serum dengan kadar metanol kuantitatif.

English Abstract

Introduction: Around the world, cases of methanol intoxication are still common, especially in countries that prohibit the sale of alcohol freely. The mortality rate due to methanol intoxication is very high. Quick and precise diagnosis is still a challenge because special laboratory tests are needed to detect the presence of methanol in the blood. General practitioners often rely solely on clinical diagnosis and simple laboratory examinations to help diagnose methanol intoxication. This study aims to determine correlation between clinical diagnosis with qualitative levels of serum Methanol and correlation between indirect laboratory examination (pH, anion gap, lactate and blood osmolality) with quantitative levels of serum methanol in methanol intoxication patients. Research Design: The research design used was analytic observational with cross sectional approach. The study subjects were patients with a suspected diagnosis of methanol intoxication in dr. Saiful Anwar, Malang, East Java during the period of July 2016 until July 2018. The location of the study was at RSU Dr. Saiful Anwar, Malang, East Java; and forensic laboratories of East Java Regional Police, Surabaya. Data was recorded in a special registry which was then carried out by the Spearman correlation test to test the correlation between indirect laboratory results (pH, anion gap, lactate and osmolality) with quantitative levels of Methanol. The Fisher Exact test and Chi square test were used to examine the relationship between clinical diagnosis and qualitative test of serum methanol. The analysis program used is SPSS 20. Results: Total 32 cases suspected of methanol intoxication, 3 cases in the exclusion criteria. Out of 29 cases, it was more common in men (83%) than women with mean age of 28.75 years. Fisher's Exact test results in p = 0.692 or greater than α = 0.05, so it was stated that there was no significant difference between clinical diagnosis and qualitative levels of serum methanol. From diagnostic tests, clinical diagnosis has a sensitivity value of 86.4% and a positive predictive value of 76% but its specificity value is only 14.3% and negative predictive value is only 25%. Spearman correlation test showed that there was a significant relationship between serum methanol levels with pH (p = <0.01), lactate (p = 0.012), anion gap (p = <0.01) and osmolality (p = 0.012). Conclusion: There was no significant relationship between clinical diagnosis and qualitative levels of serum methanol. There is a significant relationship between pH, lactate, anion gap and serum osmolality with quantitative levels of methanol.

Item Type:	Thesis (Magister)
Identification Number:	TES/362.29/RIN/h/2018/041811547
Uncontrolled Keywords:	Methanol intoxication, formic acid, diagnostic tests, indirect laboratory examination, serum methanol
Subjects:	300 Social sciences > 362 Social problems of and services to groups of people > 362.2 People with mental illness and disabilities > 362.29 Substance abuse
Divisions:	Profesi Kedokteran > Spesialis Emergensi Medisin, Fakultas Kedokteran
Depositing User:	soegeng sugeng
Date Deposited:	10 Aug 2022 03:43
Last Modified:	10 Aug 2022 03:43
URI:	http://repository.ub.ac.id/id/eprint/193103

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