ABSTRAK
Latar Belakang: Stroke merupakan penyebab kematian kedua di dunia dan diprediksi menjadi penyebab utama kematian dan kecacatan di seluruh dunia pada tahun 2020. Prognosis stroke iskemik sangat tergantung pada perbaikan penumbra di sekitar jaringan infark selama 6 jam pertama. Perbaikan penumbra dilakukan dengan menjaga perfusi jaringan tetap baik, salah satunya ditentukan oleh kadar hemoglobin dalam darah. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar hemoglobin dan prognosis pasien stroke iskemik.
Metode: Penelitian ini menggunakan design penelitian observasional dengan pendekatan studi Kohor retrospektif. Sampel diambil dari 30 pasien stroke iskemik di Bangsal dan Poliklinik RSUD Dr. Moewardi dengan teknik fixed exposure sampling. Instrumen yang digunakan adalah National Institute of Health Scale (NIHSS) dan rekam medik. Uji statistik yang digunakan adalah analisis regresi cox
Hasil: Empat dari 22 pasien (18.2%) dengan kadar Hb normal mengalami prognosis buruk Tiga dari 8 pasien (37.5%) dengan kadar Hb abnormal mengalami prognosis buruk. 3 dari 15 pasien (20%) dengan usia < 61 tahun mengalami prognosis buruk dan 4 dari 15 (26.7%) pasien dengan usia = 61 tahun mengalami prognosis buruk.
Simpulan: Pasien stroke iskemik dengan kadar hemoglobin abnormal berisiko 0.51 kali lebih rendah untuk memiliki prognosis buruk daripada pasien stroke iskemik dengan kadar hemoglobin normal, walaupun secara statistik tidak signifikan (HR = 0.51; CI = 95% 0.11 s.d. 2.28; p = 0.377).
Kata kunci: kadar hemoglobin, prognosis, stroke iskemik
ABSTRACT
Background: Stroke has been identified as second cause of death in the world, and is predicted to be the first cause of death and disability in the world in year 2020. Prognosis, after ischemic stroke’s acute phase, depends on the recovery of penumbra around the ischemic core. The recovery of penumbra is done by keeping adequate perfusion to its area. Haemoglobin (Hb) is one of many factors that affect perfusion itself. This study is aimed to analyze the correlation between hemoglobin level and prognosis of ischemic Stroke Patients in Dr. Moewardi Hospital.
Methods: This study was an analytic observational study with a retrospective cohort approach. The subjects were 30 chosen ischemic stroke patients from ward and clinic with fixed exposure sampling technique. Instruments used were National Institute of Health Stroke Scale (NIHSS) and medical records. Statistic test used was cox regression analysis.
Results: Four out of 22 patients (18.2%) with normal Hb level had a poor prognosis. Three out of 8 patients (37.5%) with abnormal Hb level had a poor prognosis. Three out of 15 patients (20%) aged < 61 had a poor prognosis, and 4 out of 15 patients (26.7%) aged = 61 had poor prognosis.
Conclusion: Ischemic stroke patients with abnormal hemoglobin level are at risk to have poor prognosis 0.51 times lower than ischemic stroke patients with normal hemoglobin level, although statistically this result was not significant (HR = 0.51; CI = 95% 0.11 to 2.28; p = 0.377)
Keywords: haemoglobin level, prognosis, ischemic stroke