Pengaruh Jumlah Leukosit terhadap Mortalitas Pasien Infark Miokard Akut selama Perawatan - Liong Boy Kurniawan; Uleng Bahrun; Mansyur Arif; Darmawaty ER (PT. Kalbe Farma Tbk., 2020)
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.