Pengaruh Lokasi Lesi Stroke Terhadap Gangguan Kognitif Vaskular Pada Pasien Paska Stroke Iskemik di RSUD Dr. Saiful Anwar Malang

Damayanti, Primita Ayu and dr. Sri Budhi Rianawati,, Sp. S (K) and dr. Catur Ari Setianto,, Sp.S (K) and dr. Alidha Nur Rakhmani,, M.Sc, Sp.D.L.P (2023) Pengaruh Lokasi Lesi Stroke Terhadap Gangguan Kognitif Vaskular Pada Pasien Paska Stroke Iskemik di RSUD Dr. Saiful Anwar Malang. Magister thesis, Universitas Brawijaya.

Abstract

Latar Belakang : Gangguan kognitif paska stroke/ vascular cognitive impairement merupakan salah satu komplikasi stroke. Stroke meningkatkan risiko gangguan kognitif setidaknya lima hingga delapan kali lipat. Gangguan kognitif vaskular / vascular cognitive impairement merupakan suatu sindrom dengan bukti klinis adanya stroke secara klinis atau lesi vaskular otak subklinis dan gangguan kognitif yang mengenai setidaknya satu domain kognitif. Secara imaging volume dan lokasi infark dapat mempengaruhi gangguan kognitif vaskular. Lokasi infark memiliki peranan yang cukup penting, bahkan infark lakunar pada lokasi strategik dapat menyebabkan gangguan kognitif. Tujuan : Mengetahui pengaruh lokasi infark dan sisi hemisfer infark berdasarkan gambaran radiologi berupa MRI kepala terhadap gangguan kognitif vaskular pada pasien paska stroke iskemik. Metode : Penelitian observasional analitik yang dengan menggunakan pendekatan cross-sectional study dengan mengambil data sekunder dari data register internal neurologi di Klinik Memori RSUD Dr. Saiful Anwar Malang. Analisa komparatif dengan uji statistik chi-square atau fisher test untuk menentukan pengaruh antara variabel lokasi infark berdasarkan gambaran MRI terhadap gangguan kognitif vaskular, kemudian, dilanjutkan dengan uji regresi multinomial untuk menentukan koefisien regresi. Untuk memastikan tidak ada faktor perancu dilakukan uji regresi logistik biner. Hasil Penelitian : Berdasarkan kriteria inklusi dan eksklusi diperoleh total 50 sampel, dimana sebagian besar pasien yang mengalami gangguan kognitif paska stroke berjenis kelamin pria, dengan rata rata usia diatas 60 tahun, pendidikan rata-rata sarjana. Dari hasil penelitian ini terdapat pengaruh lokasi infark strategik dan lokasi kombinasi (yang melibatkan lokasi strategik dan nonstrategik) terhadap gangguan kognitif vaskular dengan nilai signifikasi p = 0,014. Lokasi strategik meningkatkan risiko 7 kali (nilai odd ratio 7,333) lebih besar terhadap terjadinya demensia dibandingkan lokasi non strategik. sedangkan pada sisi lesi infark tidak mempengaruhi gangguan kognitif vaskular pada pasien paska stroke iskemik dengan nilai signifikasi p = 0,515. Kesimpulan : Terdapat pengaruh lokasi infark terhadap gangguan kognitif vaskular dimana lokasi strategik meningkatkan risiko 7 kali (nilai odd ratio 7,333) lebih besar terhadap terjadinya demensia dibandingkan lokasi non strategik. Sedangkan pada variabel sisi lesi infark tidak terdapat pengaruh sisi lesi infark terhadap gangguan kognitif vaskular pada pasien paska stroke iskemik. iv

English Abstract

Background : Vascular cognitive impairment is one complications of stroke. Stroke increases the risk of cognitive impairment at least five to eight times. Vascular cognitive impairment is a syndrome with clinical evidence of clinical stroke or subclinical brain vascular lesions and cognitive impairment affecting at least one cognitive domain. Based on imaging, volume and location infarct cause vascular cognitive impairment. Infarct location plays an important role, even lacunar infarct in strategic locations can cause cognitive impairment. Objectives : To determine the influence of the infarct location and the hemispheric side of infarct based on Magnetic Resonance Imaging for vascular cognitive impairment in patients after ischemic stroke Methode : This research is analytical observational research using a cross-sectional study approach by taking secondary data from the internal neurology registry at Memory Clinic RSUD Dr. Saiful Anwar Malang. Comparative analysis using the chi square statistical test or Fisher test to determine the influence of infarct location variables based on MRI on vascular cognitive impairement, then, continued with a multinomial regression test to determine the regression coefficient. To ensure there were no confounding factors, a binary logistic regression test was carried out. Results : Based on the inclusion and exclusion criteria, a total of 50 samples were obtained, where the majority of patients who experienced post-stroke cognitive impairment were male, with an average age of over 60 years, with an average education of a bachelor's degree. From the results of this study, there is an influence of strategic infarct location and combined location (which involves strategic and non-strategic locations) on vascular cognitive impairment with a significance value of p = 0.014. Strategic locations increase the risk 7 times (odd ratio value 7.333) of developing dementia compared to non-strategic locations. Meanwhile, the side of the infarct lesion did not affect vascular cognitive impairment in post-ischemic stroke patients with a significance value of p = 0.515. Conclusion : There is an influence of infarct location on vascular cognitive impairment where strategic locations increase the risk 7 times (odd ratio value 7.333) of developing dementia compared to non-strategic locations. Meanwhile, in terms of the side of the infarction lesion, there was no influence of the side of the infarction lesion on vascular cognitive impairment in patients after ischemic stroke.

Item Type:	Thesis (Magister)
Identification Number:	052306
Uncontrolled Keywords:	Lokasi infark, Sisi Hemisfer infark, Gangguan Kognitif Vaskular. Infarct location, Hemisphere of infarction, Vascular cognitive impairement
Divisions:	Profesi Kedokteran > Spesialis Neurologi, Fakultas Kedokteran
Depositing User:	Unnamed user with username ihwan
Date Deposited:	15 Jan 2024 02:53
Last Modified:	15 Jan 2024 02:53
URI:	http://repository.ub.ac.id/id/eprint/209761

Text (MASIH DALAM MASA EMBARGO) Primita Ayu Damayanti.pdf Restricted to Registered users only until 31 December 2025. Download (3MB)

Actions (login required)

View Item