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Wariki, Windy M. V.
Bagian Ilmu Kedokteran Komunitas, Fakultas Kedokteran, Universitas Sam Ratulangi
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Journal : MAHESA : Malahayati Health Student Journal

 1 
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 
Co-Authors Aaltje E Manampiring Aaltje E Manampiring Aaltje E. Manampiring Aaltje E. Manampiring Aaltje E. Manampiring Abram Babakal Abram Babakal Adam, Avelia Gustia Anastasya Adrian Jonathan Angir Adrian Umboh Ai Hori Alan Hopni Sasube Ari Astram B H. R. Kairupan Billy Karundeng Bogar, Bryan D. Bolang, Alexander Budi Setiawan Christof Toreh Daichi Suzuki Dalema, Anggreani Sintia Dewi Indra Purwanti Dhanny E. P. Lagarense Dina Rombot Djony E. Tjandra Doda, Diana V.D. Eko Arianto Erika Ota Fidya Lestari Putri Abubakar Fitriya Adam Frelly Kuhon Frelly V. Kuhon Frendy Wihono Goni, Angelina Grace D. Kandou Grace Korompis Gustaaf A. E. Ratag Gustaaf Ratag Harsali F. Lampus Henry M. F. Palandeng Herlyani Khosama Hessyani Raranta Idris Sudin Iftitah M. P. Sonda Ishak Halim Octawijaya Ishak Halim Octawijaya Jehosua S. V. Sinolungan Jehosua, Seilly Yunita Jimmy Posangi Jimmy Posangi John Johannes Ezechiel Wantania Karel Pandelaki Korompis, Grace Esther Caroline Lampus, Harsali Fransiscus Lotulung, Cindy Celine Lucyana Leonita Pongoh Manampiring, Aaltje E Manoppo, Firginia M Manoppo, Jeannete I Ch Manoppo, Jeannette I. Ch. Masao Ichikawa Mercy Taroreh Moh Yudawan Prasetya Momole, Ansye Grace Nancy Mukhran Mokodompit Nathaniel Pali Nelwan, Ester Jeini Ngantung, Denny Nico Lumintang Nova Hellen Kapantow Novie H. Rampengan Novita Tombokan Paskah Thalia Lengkong Pasla, Gersom Figo Chrystianto Paulus Oroh Pertiwi, Junita Maja Porajow, Zwingly C. J. G. Repi, Noviano B. Richard Sumangkut Rizal Tumewah Ronald I. Ottay Ruitan, Lidia S. Sapulete, Margareth Rosalinda Sigit Wicaksono Silaban, Natalina Simangunsong, Natasya Glory Meicharisty Stivan Manopo Sumanti, Kevin Marvil Supit, Injilia Chintami Surotinoyo, Celline Vanessa Laurina Tandililing, Sherly Tangkudung, Yesika Merzy Indah Tommy Suharso Torondek, Julia Tumboimbela, Melke Vemy Tamaledu Wangean, Yati Suriani Warouw, Finny William William Wiradarma, Elbert Wulan P. J. Kaunang Wullur, Raetasya Rachelea Rinda Wurangian, Prisilia Karina Yuansun Khosama Zeinevaltines Tampian Zwingly Christian Porajow