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Darmawaty ER, Darmawaty
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran Universitas Hasanuddin Jl. Perintis Kemerdekaan km.10 Makasar, Sulawesi Selatan 90245, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Analisis Kaitan Jumlah Trombosit dengan Mortalitas Pasien Infark Miokard Akut selama Perawatan Kurniawan, Liong Boy; Bahrun, Uleng; Arif, Mansyur; ER, Darmawaty
Cermin Dunia Kedokteran Vol 41, No 9 (2014): Diabetes Mellitus
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.615 KB) | DOI: 10.55175/cdk.v41i9.1102

Abstract

Latar belakang Trombosit berperan dalam aterotrombosis dengan menghasilkan enzim yang dapat mendegradasi matriks sehingga plak aterosklerosis mudah ruptur. Ruptur plak akan menyebabkan adhesi, aktivasi dan agregasi trombosit sehingga membentuk trombus yang dapat mematikan sel otot jantung. Jumlah trombosit diduga berkaitan dengan mortalitas pasien infark miokard akut. Tujuan Untuk mengetahui jumlah trombosit pasien infark miokard akut saat masuk rumah sakit dan menilai kaitannya dengan mortalitas pasien selama perawatan di rumah sakit. Metode Penelitian ini merupakan studi retrospektif dengan analisis potong silang, menggunakan data sekunder rekam medik 81 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit dr. Wahidin Sudirohusodo, Makassar periode Juli 2010 hingga Juni 2011. Jumlah trombosit yang diteliti adalah jumlah trombosit saat pasien masuk rumah sakit. Uji statistik dengan Uji T dan Mann Whitney. Hasil Rerata jumlah trombosit penderita infark miokard akut yang survive dan meninggal selama perawatan adalah 245,02+69,58/µL dan 259,18+111,17/µL (p=0,543). Tidak ditemukan hubungan antara tingkat mortalitas dengan jumlah trombosit secara keseluruhan (p=0,433). Pasien dengan trombositosis memiliki risiko mortalitas 4,27 kali dibandingkan dengan jumlah trombosit normal (p=0,256, 95%IK 0,368-49,676) sedangkan pasien dengan trombositopenia memiliki risiko mortalitas 1,71 kali dibandingkan dengan pasien dengan jumlah trombosit normal (p=0,471, 95%IK 0,418-6,993). Simpulan Tidak ditemukan perbedaan bermakna jumlah trombosit pasien yang survive dan yang meninggal selama perawatan, tetapi ditemukan kecenderungan peningkatan mortalitas pada pasien infark miokard akut dengan trombositosis dan trombositopenia dibandingkan dengan pasien dengan jumlah trombosit normal.Background Platelet has important role in atherothrombosis by producing enzymes which may degrade matrix leading to plaque rupture. Rupture of plaques induces platelet adhesion, activation and aggregation forming thrombus which can cause myocardial infarction. Platelet counts are thought to correlate with mortality of acute myocardial infarction patients. Objective To observe platelet counts at admission among acute myocardial patients and to evaluate its influence to in-hospital mortality. Method A retrospective study with cross sectional approach was performed using secondary data from 81 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of dr. Wahidin Sudirohusodo Hospital Makassar from June 2010 to July 2011. Platelet counts at admission were analyzed and statistical analysis was performed using T and Mann Whitney Tests. Results The mean platelet counts at admission in the in-hospital survived and non survived acute myocardial infarction patients were 245.02+69.58/µL and 259.18+111.17/µL respectively (p=0,543). No correlation found between mortality rate and overall platelet count (p=0.433). Patients with thrombocytemia had 4.27 times mortality rate compared to normal platelet counts patients (p=0.256, 95% CI =0.368-49.676) while thrombocytopenia patients had 1.71 times mortality rate compared to those with normal platelet counts (p=0.471, 95% CI =0.418-6.993). Conclusion No significant difference of platelet counts at admission in the in-hospital survived and non survived acute myocardial infarction patients; patients with thrombocytemia and thrombocytopenia had tendency of higher mortality compared to patients with normal platelet counts. 
Pengaruh Jumlah Leukosit terhadap Mortalitas Pasien Infark Miokard Akut selama Perawatan Kurniawan, Liong Boy; Bahrun, Uleng; Arif, Mansyur; ER, Darmawaty
Cermin Dunia Kedokteran Vol 42, No 10 (2015): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (185.963 KB) | DOI: 10.55175/cdk.v42i10.953

Abstract

Latar belakang: Patogenesis infark miokard akut melibatkan proses inflamasi sistemik, intraplak, ataupun miokardium. Neutrofil menginfiltrasi plak koroner dan miokardium yang mengalami infark serta memediasi terjadinya kerusakan jaringan melalui pelepasan enzim pendegradasi matriks dan spesies oksigen reaktif. Leukosit yang berperan dalam patogenesis infark miokard diduga berkaitan dengan mortalitas pasien infark miokard akut. Tujuan: Mengetahui kaitan jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit terhadap mortalitas pasien selama perawatan di rumah sakit. Metode: Studi retrospektif dengan menggunakan data sekunder dari rekam medik 64 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo, Makassar, periode Juli 2010 hingga Juni 2011. Dilakukan analisis pada jumlah leukosit, neutrofil, limfosit, dan rasio neutrofil limfosit yang diperoleh dari data hasil tes laboratorium saat pasien masuk rumah sakit. Uji statistik dilakukan dengan uji T, Mann Whitney, dan chi square. Hasil: Rerata jumlah leukosit, persentase neutrofil, limfosit, dan rasio neutrofil limfosit pada penderita infark miokard akut yang survive dan meninggal selama perawatan berturut-turut adalah 11.920+3.610/µL vs 14.410+3.090/µL (p=0,009), 73,98+11,16 vs 76,04+9,74 (p=0,647), 17,29+9,03 vs 15,00+7,00 (p=0,379), dan 5,97+3,90 vs 6,80+4,72 (p=0,403). Pasien dengan leukositosis memiliki risiko mortalitas 10,71 kali dibandingkan dengan jumlah leukosit normal (p=0,009; 95% interval kepercayaan (IK) 1,307 s/d 87,846). Simpulan: Rerata jumlah leukosit pada pasien infark miokard akut yang meninggal selama perawatan lebih tinggi dibandingkan dengan pasien yang survive. Pasien dengan leukositosis memiliki risiko mortalitas selama perawatan lebih tinggi dibandingkan pasien dengan jumlah leukosit normal.Background: Pathogenesis of acute myocardial infarction involves systemic, intraplaque, and myocardial inflammatory processes. Neutrophils infiltrated coronary plaque and infarcted myocardium, also mediate tissue damage through release of matrix degradation enzymes and reactive oxygen species. Leukocyte is suspected to be related to mortality in acute myocardial infarction patients. Objective: To investigate the relationship of leukocyte count, neutrophils and lymphocyte percentages, also neutrophils and lymphocyte ratio with in-hospital mortality of acute myocardial infarction patients. Method: A retrospective study with using secondary data from medical record of 64 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of Dr. Wahidin Sudirohusodo Hospital, Makassar, from June 2010 to July 2011. Admission leukocyte count, percentages of neutrophils and lymphocyte, and neutrophils lymphocyte ratio were analyzed statistically using T, Mann Whitney, and chi square tests. Results: The mean of leukocyte count at-admission, percentages of neutrophils and lymphocyte, and neutrophil : lymphocyte ratio in survived and non survived acute myocardial infarction patients were 11920+3610/µL vs 14410+3090/µL (p=0.009), 73.98+11.16 vs 76.04+9.74 (p=0.647), 17.29+9.03 vs 15.00+7.00 (p=0.379), and 5.97+3.90 vs 6.80+4.72 (p=0.403) respectively. Patients with leukocytosis had 10.71 times mortality rate compared to patients with normal counts (p=0.009; 95% CI =1.307-87.846). Conclusion: Leukocyte count in non-survivors was significantly higher than in survivors. Patients with leukocytosis had higher mortality risk compared with normal count patients.
Co-Authors Liong Boy Kurniawan, Liong Boy Mansyur Arif Uleng Bahrun, Uleng