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Studi Meta-Analisis Transcranial Doppler Terhadap Glasgow Outcome Score Pada Cedera Otak Traumatik William, William; Tumewah, Rizal; Ngantung, Denny; Pertiwi, Junita Maja; Tumboimbela, Melke; Wariki, Windy Mariane Virenia
MAHESA : Malahayati Health Student Journal Vol 5, No 7 (2025): Volume 5 Nomor 7 (2025)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v5i7.18851

Abstract

ABSTRACT Traumatic brain injury (TBI) through primary and secondary brain injury causes ischemic, hypoxic, cerebral edema, increased intracranial pressure, which are related to physiological, emotional damage and disability. Transcranial Doppler (TCD) as a diagnostic tool can monitor increased intracranial pressure through hypoperfusion and also monitor vasospasm. This meta-analysis study aims to determine TCD as a diagnostic tool in predicting outcomes in TBI cases. Observational studies were taken on TCD examination in TBI cases. Clinical outcomes were assessed based on the Glasgow Outcome Score (GOS), Glasgow Outcome Score-Extended (GOS-E), and mortality. Secondary outcomes were the cut-off values of the Pulsatility Index (PI) and Lindegaard Ratio (LR) related to GOS, GOSE and mortality. Abnormal TCD values in TBI cases would have a >11 times greater likelihood of poor GOS (OR 11.51, 95% CI 7.75 to 17.10). Abnormal TCD had a >11 times greater likelihood of causing death compared to normal TCD (OR 11.05, 95% CI 5.99 to 20.40). Hypoperfusion on TCD had a >6 times greater likelihood of being associated with poor GOS (OR 6.33, 95% CI 0.28 to 144.48) and had a >22 times greater likelihood of causing death compared to vasospasm on TCD (OR 22.86, 95% CI 0.70 to 751.27). ROC curve analysis showed that the PI cut-off value of 1.03 and LR 3.3 were associated with poor GOS. TCD can be used as a diagnostic tool to predict poor GOS outcomes and mortality in TBI cases. Keywords: Transcranial Doppler, Glasgow Outcome Score, Traumatic Brain Injury ABSTRAK Cedera otak traumatik (COT) melalui cedera otak primer dan sekunder menyebabkan proses iskemik, hipoksik, edema serebral, kenaikan tekanan intrakranial, yang berkaitan dengan kerusakan fisiologis, emosional dan disabilitas. Transcranial Doppler (TCD) sebagai alat penunjang diagnostik dapat memantau kenaikan tekanan intrakranial melalui hipoperfusi dan juga memantau vasospasme. Studi meta-analisis ini bertujuan untuk menentukan TCD sebagai alat penunjang diagnostik dalam memprediksi luaran pada kasus COT. Studi observasional pemantauan TCD pada kasus COT diambil untuk dilakukan meta-analisis. Luaran klinis dinilai berdasarkan Glasgow Outcome Score (GOS), Glasgow Outcome Score-Extended (GOS-E), dan mortalitas. Luaran sekunder berupa nilai cut-off Pulsatility Index (PI) dan Lindegaard Ratio (LR) yang berhubungan dengan GOS, GOSE dan mortalitas. Nilai abnormal pada TCD akan memiliki kemungkinan >11 kali luaran GOS buruk (OR 11.51, 95% CI 7.75 to 17.10). TCD abnormal memiliki kemungkinan >11 kali menyebabkan kematian dibandingkan TCD normal (OR 11.05, 95% CI 5.99 to 20.40). Hipoperfusi pada TCD memiliki kemungkinan >6 kali berkaitan dengan GOS buruk (OR 6.33, 95% CI 0.28 to 144.48) dan memiliki kemungkinan >22 kali menyebabkan kematian dibandingkan vasospasme pada TCD (OR 22.86, 95% CI 0.70 to 751.27). Analisis kurva ROC memperlihatkan nilai cut-off PI 1.03 dan LR 3.3 berkaitan dengan GOS yang buruk. TCD dapat digunakan sebagai alat diagnostik untuk memprediksi luaran GOS buruk dan mortalitas pada kasus COT. Kata Kunci: Transcranial Doppler, Glasgow Outcome Score, Cedera Otak Traumatik 
Hubungan Rasio Trigliserida-High Density Lipoprotein pada Luaran Stroke Iskemik di RSUP Prof. Dr. R. D. Kandou Manado Pambudi, Denny; Tumboimbela, Melke; Tangkudung, Gilbert
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i4.406

Abstract

ABSTRACT Introduction: Stroke is one of the causes of mortality and long-term disability in the world. Triglyceride ratio-high-density lipoprotein is an objective parameter that has been validated as a prognostic tool for outcome 3 months after ischemic stroke. Aim: To determine the relationship between triglyceride- high-density lipoprotein with ischemic stroke outcome. Methods: This study was a retrospective observational cross-sectional study in acute ischemic stroke patients treated at Prof dr. R. D Kandou Manado hospital taken by consecutive sampling. The bivariate test was analyzed using a simple linear regression method. Results: 150 acute ischemic stroke patients were included in this study, with an average age of 60.00±10.10 years, compromising 57.3% men, and average TG/HDL ratio of 3.51. Barthel's outcomes with mild dependence were 62%, while the good mRS outcomes were 52.67%. Linear regression test of the TG/HDL ratio on the Barthel scale, obtained the value of r=0.19 and the value of R square=0.038, with a value of p=0.018, and the regression line equation of the Barthel value=65.31+(-1.27) TG/HDL ratio. Whereas to the mRS scale, the value of r=0.18 and the value of R square=0.032, with a value of p=0.028, and the regression line equation of the mRS value=3.058+0.60 TG/HDL ratio. Discussion: : TG/HDL ratio has a negative relationship on the Barthel scale and a positive relationship on the mRS scale, with a weak correlation value. TG/HDL ratio is considered as an independent parameter that predict ischemic stroke outcome. Keywords: Triglycerides, high-density lipoprotein , Ischemic Stroke, Outcome