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Lisda Amalia
Departemen Neurologi FK Universitas Padjadjaran, Bandung
Health Professions Medicine & Pharmacology Neuroscience

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HUBUNGAN PERDARAHAN GASTROINTESTINAL DENGAN LUARAN PASIEN STROKE ISKEMIK AKUT Rico Defryantho; Lisda Amalia; Ahmad Rizal; Suryani Gunadharma; Siti Aminah; Nushrotul Lailiyya
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.58

Abstract

     ASSOCIATION BETWEEN GASTROINTESTINAL BLEEDING WITH CLINICAL OUTCOME ACUTE ISCHEMIC STROKE PATIENTABSTRACTIntroduction: Gastrointestinal bleeding associated by the delay in the administration of antiplatelet and anticoagulant, thus affected the clinical outcome and patient treatment.Aims: To find the association between gastrointestinal bleeding and clinical outcome in acute ischemic stroke patient.Methods: This study was a prospective observational, conducted at Hasan Sadikin Hospital Bandung in November 2017 to February 2018. Acute ischemic stroke patients that fulfill the inclusion and exclusion criteria were observed while being treated in the ward and the survival rate and length of stay were studied. This study used univariate, bivariate, multivariate, and stratification analysis.Results: In the study period, 100 acute ischemic stroke patients were found and 24 patients had gastrointestinal bleeding. A history of previous peptic ulcer/gastrointestinal bleeding was found in patient with gastrointestinal bleeding (20.8%). Median NIHSS score was higher (16 vs 7) and GCS score was lower (12 vs 15) in patients with bleeding. Multivariate analysis showed that gastrointestinal bleeding were significantly associated with survival and length of stay. The analysis of stratification showed subjects with infections who later experienced gastrointestinal bleeding had a lower risk of death and length of stay than subjects without infection who experienced gastrointestinal bleeding (1.7  vs  22.5 times and 1.5 vs 2 times).Discussion: Ischemic stroke with gastrointestinal bleeding had higher mortality and length of stay than without gastrointestinal bleeding in acute ischemic stroke patient.Keyword: Acute ischemic stroke, gastrointestinal bleeding, length of stay, mortalityABSTRAKPendahuluan: Perdarahan gastrointestinal berhubungan dengan penundaan terapi antiplatelet atau antikoagulan, sehingga berpengaruh terhadap luaran dan tata laksana pasien.Tujuan: Mengetahui hubungan perdarahan gastrointestinal dengan luaran pasien stroke iskemik akut.Metode: Penelitian prospektif observasional terhadap pasien stroke iskemik akut di RSUP Dr. Hasan Sadikin, Bandung pada bulan November 2017 hingga Februari 2018. Pasien stroke iskemik akut yang memenuhi kriteria inklusi dan eksklusi diobservasi selama perawatan untuk mengetahui survival dan lama perawatan di rumah sakit. Analisis statistik yang digunakan adalah univariat, bivariat, multivariat, dan stratifikasi.Hasil: Selama periode penelitian didapatkan 100 subjek stroke iskemik akut dengan 24 subjek mengalami perdarahan gastrointestinal. Riwayat ulkus peptikum/perdarahan gastrointestinal sebelumnya sebanyak 20,8% pada perdarahan gastrointestinal. Median skor NIHSS lebih tinggi (16 vs 7) dan skor GCS lebih rendah (12 vs 15) pada perdarahan. Analisis multivariat didapatkan perdarahan gastrointestinal memiliki hubungan signifikan dengan survival dan lama perawatan. Berdasarkan analisis stratifikasi subjek dengan infeksi yang kemudian mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih rendah dibandingkan subjek tanpa infeksi kemudian mengalami perdarahan gastrointestinal (1,7 vs 22,5 kali dan 1,5 vs 2 kali).Diskusi: Stroke iskemik akut yang mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih tinggi dibandingkan tanpa perdarahan gastrointestinal.Kata kunci: Lama perawatan, mortalitas, perdarahan gastrointestinal, stroke iskemik akut
HUBUNGAN LUARAN SUBJECTIVE GLOBAL ASSESSMENT (SGA) DENGAN DERAJAT KEPARAHAN STROKE Lisda Amalia; Fadila Arsanti; Ginna Megawati
NEURONA Vol 36 No 3 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i3.71

Abstract

   ASSOCIATION BETWEEN SUBJECTIVE GLOBAL ASSESSMENT (SGA) OUTCOMES AND STROKE SEVERITYABSTRACTIntroduction: Stroke is a cerebrovascular disease caused by the sudden death of brain cells. Nutrition plays an important role in stroke. Inadequate intake of nutrients affects severity of stroke. Subjective Global Assessment (SGA) can be used to assess the nutritional status of stroke patients, while severity of stroke is known by assessing neurological deficits based on the National Institute of Health Stroke Scale (NIHSS).Aims: To determine the association between SGA outcomes and stroke severity based on NIHSS.Methods: A cross-sectional study with consecutive sampling in stroke patients who were treated in the neurological ward of Dr. Hasan Sadikin Hospital, Bandung between August-October 2018. Subjective Global Assessment and NIHSS were assessed. Alternative statistical test Fisher’s exact test was used to see the relationship between these two variables.Results: Among 40 patients, 57.5% were female, 37.5% had a stroke at the age of 50-59 years, the main risk factor of stroke was hypertension. Recurrence stroke were more common (52.5%), with most of them were ischemic stroke (60%). The most common neurological deficit was hemiplegia. Subjects with malnutrition (SGA C) were 40%. Fifty percent patients had moderate neurological deficits based on NIHSS. The association between variables by Fisher’s exact test was 0.008.Discussion: There was a significant association between SGA outcomes and stroke severity based on NIHSS.Keywords: NIHSS, nutritional status, SGA, stroke severityABSTRAKPendahuluan: Stroke merupakan penyakit serebrovaskular yang disebabkan adanya kematian mendadak sel otak. Nutrisi berperan penting pada stroke. Asupan nutrisi yang tidak adekuat berpengaruh terhadap derajat keparahan stroke. Subjective Global Assessment (SGA) dapat menilai status gizi pasien stroke, sedangkan derajat keparahan stroke diketahui dengan menilai defisit neurologis berdasarkan National Institute of Health Stroke Scale (NIHSS).Tujuan: Mengetahui hubungan antara luaran SGA dengan derajat keparahan stroke berdasarkan NIHSS.Metode: Analisis potong lintang dengan consecutive sampling pada pasien stroke yang dirawat di bangsal Neurologi RSUP Dr. Hasan Sadikin, Bandung bulan Agustus-Oktober tahun 2018. Variabel yang dinilai pada penelitian adalah SGA dan NIHSS. Uji alternative Fisher’s exact test digunakan untuk melihat hubungan antar variabel.Hasil: Dari 40 subjek penelitian sebanyak 57,5% berjenis kelamin perempuan, 37,5% mengalami stroke pada usia50–59 tahun, memiliki faktor risiko utama hipertensi. Stroke berulang lebih banyak terjadi (52,5%), jenis stroke terbanyak adalah iskemik (60%). Defisit neurologis terbanyak yaitu hemiplegia. Subjek dengan gizi buruk (SGA C) sebanyak 40%. Derajat keparahan NIHSS dengan defisit neurologis sedang yaitu 50%. Hubungan antar kedua variabel, uji alternative Fisher’s exact test memperoleh hasil 0,008.Diskusi: Terdapat hubungan yang bermakna antara luaran SGA dengan derajat keparahan stroke berdasarkan NIHSS.Kata kunci: Derajat keparahan stroke, NIHSS, SGA, status gizi
Co-Authors Ahmad Rizal Fadila Arsanti Ginna Megawati Nushrotul Lailiyya Rico Defryantho,* Lisda Amalia,* Ahmad Rizal,** Suryani Gunadharma,* Siti Aminah,* Nushrotul Lailiyya* Siti Aminah Suryani Gunadharma