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Renindra Ananda Aman
Departemen Bedah Saraf, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo
Religion Humanities Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics Public Health Other

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PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
PERBEDAAN NILAI LEUKOSIT PRA- DAN PASCAOPERASI SEBAGAI PREDIKTOR LUARAN FUNGSIONAL PERDARAHAN INTRASEREBRAL SPONTAN Hanif Gordang Tobing; Bismo Nugroho PPR; Mohamad Saekhu; Setyo Widi Nugroho; Affan Priyambodo; Wismaji Sadewo; Syaiful Ichwan; Renindra Ananda Aman; David Tandian; Samsul Ashari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.68

Abstract

          DIFFERENCES BETWEEN PRE- AND POST-SURGERY LEUKOCYTE COUNTS AS FUNCTIONAL OUTCOME PREDICTOR IN SPONTANEOUS INTRACEREBRAL HEMORRHAGEABSTRACTIntroduction: Hematoma in spontaneous intra-cerebral  hemorrhage (SICH) results inflammation due to secondary brain injury. Leukocyte, an inflammation indicator which is routinely examined, known as an outcome predictor in non- operated SICH. The role of inflammation in operated SICH is still unknown, however, pre- and post-surgery leukocyte counts can be a marker of brain tissue damage (brain injury).Aim: This study investigated the characteristics of leucocyte parameters in operated SICH patients and its correlation to functional outcome based on Glasgow Outcome Scale (GOS).Methods: This was a retrospective cohort study for SICH patients who underwent surgery at Department of Neurosurgery in Dr. Cipto Mangunkusumo National General Hospital from January 2012–March 2017. This study analyzed the association between pre-operative leucocyte level with age, pre-operative GCS, hemorrhage volume, length of hospitalization, and  six-month post-operative GOS. The correlation of differences of pre-operative and one-day post- operative leucocyte counts with six-month post-operative GOS and hematoma evacuation percentage were analyzed. The analysis was done using Pearson correlation test, Spearman, Chi-square χ2 test, Fisher exact test, and Anova test.Results: There was a significant correlation  between differences of leukocyte counts in pre- and post-surgery with GOS. A higher post-surgery leukocyte difference would lower GOS; there was a significant correlation between the leukocytes counts in pre-operative leucocyte and GCS. A higher pre-operative leukocytes counts would lower the GCS.Discussion: The differences of pre-operative and post-operative leucocyte counts is a functional outcome predictors within 6 months in operated SICH patients.Keywords: Leukocyte, outcome, spontaneous intracerebral hemorrage, surgeryABSTRAKPendahuluan: Hematoma pada perdarahan intraserebral spontan (PISS) menyebabkan inflamasi akibat cedera otak sekunder. Leukosit sebagai indikator inflamasi yang rutin diperiksa, diketahui memiliki peranan sebagai prediktor luaran pada PISS yang tidak dioperasi. Sejauh ini belum diketahui peranan inflamasi pada PISS yang dioperasi, namun kadar leukosit pra- dan pascaoperasi dapat menjadi penanda adanya kerusakan jaringan otak (brain injury).Tujuan: Untuk mengetahui karakteristik parameter leukosit pasien PISS yang dioperasi dan kaitannya dengan luaran fungsional berdasarkan skor Glasgow Outcome Scale (GOS).Metode: Studi kohort retrospektif pada pasien PISS yang dioperasi di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2012-Maret 2017. Dilakukan analisis antara nilai leukosit praoperasi dengan usia, GCS praoperasi, volume perdarahan, lama rawat inap, dan skor GOS 6 bulan pascaoperasi. Dilakukan analisis perbedaan nilai leukosit praoperasi dibandingkan hari pertama pascaoperasi dengan skor GOS 6 bulan pascaoperasi dan persentase evakuasi hematoma. Analisis dilakukan menggunakan korelasi Pearson, Spearman, uji Chi-square χ2  test, Uji Fisher exact test, dan Anova.Hasil: Pada uji statistik didapatkan korelasi bermakna antara perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi dengan skor GOS. Semakin tinggi nilai perbedaan leukosit pascaoperasi akan menurunkan skor GOS; didapatkan korelasi bermakna antara leukosit praoperasi dengan GCS praoperasi. Semakin tinggi leukosit praoperasi, semakin rendah GCS.Diskusi: Perbedaan nilai leukosit pascaoperasi dibandingkan praoperasi merupakan prediktor luaran fungsional dalam 6 bulan pada pasien perdarahan intraserebral spontan yang dioperasi.Kata kunci: Leukosit, luaran, operasi, perdarahan intraserebral spontan 
PASCAOPERASI ADENOMA HIPOFISIS: HUBUNGAN ANTARA DURASI AWITAN DENGAN LUARAN KLINIS VISUS DAN LAPANG PANDANG Renindra Ananda Aman; Reki Setiawan; Retno Asti Werdhani; Samsul Ashari; David Tandian; Syaiful Ichwan; Affan Priyambodo; Setyo Widi Nugroho
NEURONA Vol 37 No 3 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.161

Abstract

Introduction: Pituitary adenomas can cause decrease of visual acuity (VA), narrowing visual field (VF). Several studies have showed that the duration of complaints were related significantly with clinical outcomes. As a national referral center hospital, all pituitary adenoma patients who came to our institution were referred from ophthalmologists, neurologists, and neurosurgeons from other institutions. Aim: In this study, we investigated the relationship between duration, which is calculated from the time of symptoms first appeared to the time of surgery, and outcome (VA and VF) in pituitary adenoma patients who underwent transsphenoidal surgery. Methods: A retrospective design was used on pituitary adenoma patients that underwent transsphenoidal surgery between 2015-2017 in Cipto Mangunkusumo Hospital. The duration between symptoms’ onset and surgery was calculated in months. VA and VF examinations were performed 1 day before surgery and within 1 to 2 months postoperatively. Results: There were 71 patients (36 male, 35 female) with decreased VA and narrowed VF, with a median age of 42 years (20-77 years). The median length of duration of onset for both symptoms was 12 months (1-108 months). 40.5% patients had improved VA postoperatively, with median duration of onset of 11 months. Improvement in VF was experienced in 67.6% patients, with median duration of onset of 12 months. Discussion: There was a statistically significant relationship between the duration of onset and the VF outcomes. Improvements in the VF were found in patients who underwent surgery up to 12 months after the time of onset. Keywords: Pituitary adenoma, transsphenoidal surgery, visual acuity, visual field
EVALUASI TAJAM PENGLIHATAN DAN INDEKS PROPTOSIS PASIEN MENINGIOMA SPHENOORBITA PASCAOPERASI KRANIEKTOMI Renindra Ananda Aman; Ryan Rhiveldi Keswani; Syaiful Ichwan; Samsul Ashari; Setyo Widi Nugroho
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.171

Abstract

Introduction: Sphenoorbital meningioma (SOM) is an exophytic tumor mass that infiltrates the bone at the sphenoid wing, lateral orbital walls, orbital roofs, and extends to superior orbital fissures. The classic triad of clinical features are proptosis, decreased visual acuity, and ophthalmoplegia. The outcomes of our postoperative patients have not been evaluated before. Aim: We would like to evaluate the clinical characteristics of the sphenoorbital menigioma patients before and after surgery. Methods: A cross sectional study was performed. Subjects were patients with sphenoorbital meningiomas who came to Cipto Mangunkusumo General Hospital from January 2014 through December 2015. All patients underwent craniectomy and lateral orbitotomy. We evaluated the visual acuity using the Snellen chart and proptosis index before and after surgery by measuring the protuded eye in an axial CT scan. Results: There were 66 samples in this study, and 65 of the samples were females. The age range is from 31 to 64 years. The mean proptosis index of preoperative is 18.27 and the post operative is 16.43. The mean proptosis index reduction is 1.84. Post operative visual acuity was improved only in 3 (9.7%) samples. Discussion: Sphenoorbital meningioma patients after surgery were shown markedly improvement in the proptosis index. However, the visual acuity was not markedly improved after surgery. Keywords: Proptosis index, sphenoorbital meningioma, visual acuity
HUBUNGAN WAKTU TUNGGU MENUJU OPERASI PENGANGKATAN TUMOR INTRAKRANIAL DENGAN SKALA PERFORMA KARNOFSKY PASCAOPERASI Setyo Widi Nugroho; Aryandhito Widhi Nugroho; Renindra Ananda Aman; Hanif Gordang Tobing
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.175

Abstract

Introduction: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown, let alone its association with postoperative functional outcome. Aim: To identify the waiting time to elective intracranial tumor removal and to analyze its association with poor functional outcome, defined by 3-months postoperative Karnofsky Performance Scale (KPS score) of <70. Methods: This medical record-based retrospective study was performed on intracranial tumor patients underwent elective tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to determine any significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome, adjusting for age, sex, preoperative KPS score, pre- and postoperative tumor volume, percentage of tumor removal, tumor histopathology, and grading. Results: Data were obtained from 191 patients, with histopathology distributions as follows: 49% meningiomas, 22% pituitary adenomas, 9% astrocytomas, 3% metastatic tumors, 3% primary central nervous system lymphomas, 2% oligodendrogliomas, 2% craniopharyngiomas, and 10% others. Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was evident in univariable analysis (OR 1.004), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were, respectively, 5.92; 5.69; and 3.2. Discussion: There was no significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome. Strong collinearities were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery. Keywords: functional outcome, intracranial tumor, removal surgery, waiting time
HUBUNGAN WAKTU TUNGGU MENUJU OPERASI PENGANGKATAN TUMOR INTRAKRANIAL DENGAN SKALA PERFORMA KARNOFSKY PASCAOPERASI Setyo Widi Nugroho; Aryandhito Widhi Nugroho; Renindra Ananda Aman; Hanif Gordang Tobing
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.175

Abstract

Introduction: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown, let alone its association with postoperative functional outcome. Aim: To identify the waiting time to elective intracranial tumor removal and to analyze its association with poor functional outcome, defined by 3-months postoperative Karnofsky Performance Scale (KPS score) of <70. Methods: This medical record-based retrospective study was performed on intracranial tumor patients underwent elective tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to determine any significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome, adjusting for age, sex, preoperative KPS score, pre- and postoperative tumor volume, percentage of tumor removal, tumor histopathology, and grading. Results: Data were obtained from 191 patients, with histopathology distributions as follows: 49% meningiomas, 22% pituitary adenomas, 9% astrocytomas, 3% metastatic tumors, 3% primary central nervous system lymphomas, 2% oligodendrogliomas, 2% craniopharyngiomas, and 10% others. Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was evident in univariable analysis (OR 1.004), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were, respectively, 5.92; 5.69; and 3.2. Discussion: There was no significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome. Strong collinearities were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery. Keywords: functional outcome, intracranial tumor, removal surgery, waiting time
GAMBARAN ARSITEKTUR TIDUR PADA PASIEN TUMOR OTAK YANG MENGALAMI GANGGUAN TIDUR Yesi Astri; Manfaluthy Hakim; Tiara Aninditha; Renindra Ananda Aman; Astri Budikayanti
NEURONA Vol 38 No 2 (2021)
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Abstract

Introduction: Sleep disorder is commonly found in brain tumor patients (42-46%). It can be detected using thePittsburg Sleep ????uality Inde???? (PS????I) as a screening tool and confirmed by analyzing the sleep architecture obtainedthrough a Polysomnographic (PSG) examination.Aim: To evaluate the sleep architecture in brain tumor patients who experience sleep disorder.Methods: In this descriptive cross-sectional study, patients with primary brain tumor were screened for sleep disorderusing the PSQI. The ‘poor sleepers’ would proceed to PSG examination.Results: Of 40 participants, 14 were males and 26 were females with a mean age of 45.5±11.7 years old. The mostprevalent tumor was meningioma (42.5%), while the most affected regions were the frontal lobe (40%) and the sellarsuprasellarregion (2????.5%). Poor sleep ????uality and difficulty in initiating sleep (????3 times per week) was reported in77.5% and 60% of participants, respectively. All participants experienced reduced sleep duration, the majority of whichdemonstrated low sleep efficiency (8????.5%). An estimate of 60% participants e????perienced headache at night and 50% tooksleeping pills for these complaints. Most of them reported disruption in daytime activities. On PSG analysis, we observedshortening of sleep latency, reduced sleep efficiency, total sleep time, N2, N3, REM, arousal inde????, and increase of N1.There was a statistically significant difference between ????5 hours of sleep duration and decrease of N3 phase (p????0.05).Discussion: Abnormal sleep architecture presents in brain tumor patients with sleep disorder.Keywords: brain tumor, Pittsburgh Sleep Quality Index, polysomnography, sleep architecture
KOMPLIKASI VENTRIKULOPERITONEAL SHUNT PADA PASIEN PEDIATRIK USIA 0-2 TAHUN DI RUMAH SAKIT UMUM PUSAT NASIONAL DR CIPTOMANGUNKUSUMO Samsul Ashari; Bhayu Rizallinoor; Hilman Mahyudin; Moh. Saekhu; Renindra Ananda Aman; David Tandian; Abdi Reza; Setyo Widi Nugroho
NEURONA Vol 38 No 2 (2021)
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Abstract

Introduction: Ventriculoperitoneal shunt is the procedure of choice in the management of hydrocephalus. However,the ventriculoperitoneal shunt procedure also carries a risk of complications. In Indonesia, data on the incidence andprevalence of ventriculoperitoneal shunt complications have not been obtained.Aim: In this study, we examined the complications of shunts and the factors associated with the duration of timeMethods: This study is a retrospective study of pediatric patients aged 0-2 years with hydrocephalus who underwentventriculoperitoneal shunt surgery for the first time at Cipto Mangunkusumo Hospital in 2015-2020 and e????periencedcomplications. The duration of time the complications occurred was divided into before and after six months. Demographicdata, clinical data, and types of complications were analyzed descriptively.Result: From ????anuary 2015 to March 2020 at Cipto Mangunkusumo Hospital, 168 ventriculoperitoneal shuntoperations were performed at 0-2 years. It was found that 20 patients (12%) e????perienced complications with a duration offewer than si???? months by ????.8% and more than si???? months by 4.2%. The total complications that occurred were mechanicalcomplications (????.2%), infection (3.6%), and over drainage (1.2%).Discussion: The percentage of complications of ventriculoperitoneal shunt in patients aged 0-2 years at CiptoMangunkusumo Hospital, in the first si???? months was ????.8%, with the highest incidence was infection (3.6%) which waslower than the literature, while the percentage of complications of ventriculoperitoneal shunts which more than six monthswere 4.2% and caused mainly by distal malfunction (3%).Keywords: aged 0-2 years, complications, pediatric, ventriculoperitoneal shunt
RASIO NEUTROFIL LIMFOSIT SEBAGAI PREDIKTOR LUARAN KASUS CEDERA KEPALA SEDANG DAN BERAT: STUDI MULTISENTER Hanif Gordang Tobing; Yovanka Naryai Manuhutu; Syaiful Ichwan; Renindra Ananda Aman; Setyo Widi Nugroho; Samsul Ashari; David Tandian; Mohammad Saekhu; Wismaji Sadewo; Affan Priyambodo; Kevin Gunawan; Ande Fachniadin
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Traumatic brain injury (TBI) is the most common cause of death in populations less than 40 years old in developed and developing countries. The clinical outcome after TBI is still an issue and difficult to predict. Besides Glasgow Coma Scale (GCS), neutrophil to lymphocyte ratio (NLR) as one of the neuroinflammation biomarkers also can predict outcomes after TBI Aim: To measure the association between NLR and GCS as predictors of moderate and severe TBI outcomes. Methods: This prospective study included moderate and severe TBI patients who underwent craniotomy in a multicenter hospital from November 2019 to November 2020. Chi-square analytic test was used to determine the relationship between demographics, clinical symptoms, NLR and GCS as predictors outcome of moderate and severe TBI. Results: About 54 patients with moderate and severe TBI consist of 41 (75.9%) male and 13 (24.1%) female patients, mean age 27.6 ± 15.3 years, preoperative GCS is 13 (7 - 13), with asymmetric pupil 33 (61.1%), seizures 5 (9.3%), hemiparesis 1 (1.86%), and GCS postoperative on the fifth and seventh day is 14 (6 - 15). Preoperative NLR was 7.4 (1.9-26.2), the cut-off for NLR as a predictor for improved GCS was at 9.8 with a specificity and sensitivity of 87%. Discussion: Low NLR had an association with the patient’s improved GCS, while a high NLR had an association with a non-improving GCS, so that the relationship between RNL and GCS could be used as an outcome predictor of moderate and severe traumatic brain injury patient. Keywords: glasgow coma scale, neutrophil to lymphocyte ratio, predictor, traumatic brain injury
RASIO NEUTROFIL LIMFOSIT SEBAGAI PREDIKTOR LUARAN KASUS CEDERA KEPALA SEDANG DAN BERAT: STUDI MULTISENTER Hanif Gordang Tobing; Yovanka Naryai Manuhutu; Syaiful Ichwan; Renindra Ananda Aman; Setyo Widi Nugroho; Samsul Ashari; David Tandian; Mohammad Saekhu; Wismaji Sadewo; Affan Priyambodo; Kevin Gunawan; Ande Fachniadin
NEURONA Vol 38 No 3 (2021)
Publisher : PERDOSNI

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Abstract

Introduction: Traumatic brain injury (TBI) is the most common cause of death in populations less than 40 years old in developed and developing countries. The clinical outcome after TBI is still an issue and difficult to predict. Besides Glasgow Coma Scale (GCS), neutrophil to lymphocyte ratio (NLR) as one of the neuroinflammation biomarkers also can predict outcomes after TBI Aim: To measure the association between NLR and GCS as predictors of moderate and severe TBI outcomes. Methods: This prospective study included moderate and severe TBI patients who underwent craniotomy in a multicenter hospital from November 2019 to November 2020. Chi-square analytic test was used to determine the relationship between demographics, clinical symptoms, NLR and GCS as predictors outcome of moderate and severe TBI. Results: About 54 patients with moderate and severe TBI consist of 41 (75.9%) male and 13 (24.1%) female patients, mean age 27.6 ± 15.3 years, preoperative GCS is 13 (7 - 13), with asymmetric pupil 33 (61.1%), seizures 5 (9.3%), hemiparesis 1 (1.86%), and GCS postoperative on the fifth and seventh day is 14 (6 - 15). Preoperative NLR was 7.4 (1.9-26.2), the cut-off for NLR as a predictor for improved GCS was at 9.8 with a specificity and sensitivity of 87%. Discussion: Low NLR had an association with the patient’s improved GCS, while a high NLR had an association with a non-improving GCS, so that the relationship between RNL and GCS could be used as an outcome predictor of moderate and severe traumatic brain injury patient. Keywords: glasgow coma scale, neutrophil to lymphocyte ratio, predictor, traumatic brain injury
Co-Authors Abdi Reza Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Affan Priyambodo Ahmad Yanuar Amelia, Ria Andayani, Diyah Eka Ande Fachniadin Anggraini, Neni Tri Aninditha, Tiara Aryandhito Widhi Nugroho Aryandhito Widhi Nugroho Bhayu Rizallinoor Bismo Nugroho Bismo Nugroho PPR Budiman Darmowidjojo, Budiman Calvin, Nicholas David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian David Tandian Dewiputri, Salmarezka Eka Susanto Esthika Dewiasty, Esthika Fabianto Santoso Fauzan Herdian Fenny Tjuatja Fitrie Desbassarie, Fitrie Harris Istianggoro Henry Kodrat Hilman Mahyuddin Hilman Mahyudin Ina S. Timan Jeremia Prasetya Pardede Jeremia Prastya Pardede Kevin Gunawan Kurniawan, Azhar Farisyabdi Liza Amelia M, Sidik Martin Susanto Moh. Saekhu Mohamad Saekhu Mohammad Saekhu Muhammad Harisyah Mutmainah Mutmainah Nina Asrini Noor Nugroho, Setyo Widi Nurwahyuni, Atik Paat, Bipatra Einstein Yacobus Padmo Santjojo Paramita Ayuningtyas, Sita Pradana Soewondo Priyambodo, Affan Purwodito, Arief Putri Auliya, Putri Rahma Putri, Herdanti Rahmad Mulyadi Rahmat Cahyanur Reki Setiawan Renindra A Aman Renindra A. Aman Renindra A. Aman Retno Asti Werdhani Rini Andriani Riwanti Estiasari Ryan Rhiveldi Keswani Sadewo, Wismaji Samsul Ashari Samsul Ashari Samsul Ashari Samsul Ashari Samsul Ashari SAMSUL ASHARI, SAMSUL Setyo W. Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Setyo Widi Nugroho Soehartati A Gondhowiardjo Soehartati A. Gondhowiardjo Soehartati Gondhowiardjo Soehartati Gondhowiardjo Sofyan, Henry Riyanto Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syaiful Ichwan Syarif, Ricky Rusydi Syntia Nusanti Tanjung, Gloria Tiara Aninditha Tiara Aninditha Tiara Bunga Mayang Permata Wimbo, Fitrie Desbassarie Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Wismaji Sadewo Yesi Astri Yovanka Naryai Manuhutu Yulius Seno Nugroho