Korelasi antara kadar albumin serum dengan Skala Stroke Gadjah Mada (SSGM) pada penderita stroke iskemik akut

DANANJOYO, Kusumo, dr. Pernodjo Dahlan, Sp.S(K)

2010 | Tesis |

Stroke atau serangan otak (brain attack) adalah defisit neurologis yang mendadak pada susunan saraf pusat yang disebabkan oleh peristiwa iskemik atau hemoragik. Konsentrasi albumin serum telah lama diketahui sebagai indikator kasar keadaan kesehatan umum individu. Konsentrasi albumin serum sedang sampai sangat rendah berhubungan dengan morbiditas dan semua penyebab mortalitas pada orang dewasa. Penelitian ini untuk mengetahui korelasi kadar albumin serum terhadap defisit neurologis pada penderita stroke iskemik akut. Metode pada penelitian ini mempergunakan rancangan penelitian crosssectional (potong lintang). Subjek penelitian diambil pasien-pasien yang dirawat di Unit Stroke dan Bangsal Saraf RSUP Dr. Sardjito Yogyakarta, didiagnosis sebagai stroke iskemik akut berdasarkan anamnesis, pemeriksaan klinis dan pemeriksaan CTscan kepala yang memenuhi kriteria inklusi. umur pasien, jenis kelamin, tingkat pendidikan, kadar albumin serum, status merokok, kadar gula darah sewaktu, dan riwayat DM, riwayat stroke, hipertensi, riwayat penyakit jantung, dan hipodens awal pada CT-scan kepala digunakan dalam analisis. Korelasi antara kadar albumin serum dengan SSGM dilakukkan uji korelasi Spearman’s test dan uji regresi linier untuk analisis multivariat. Hasil dianggap bermakna secara statistik apabila nilai p<0,05. Sebanyak 82 orang subjek dimasukkan dalam penelitian. Hasil analisis menunjukkan bahwa kadar albumin serum berkorelasi terhadap SSGM (r=0,405; p=0,001). Variabel lain yang memiliki hubungan bermakna dengan SSGM adalah jenis kelamin, riwayat sakit jantung, penurunan kesadaran, riwayat stroke, letak lesi, suhu tubuh, gula darah sewaktu, kadar ureum, total protein, angka lekosit dan kadar kalium. Dalam analisis multivariat, hanya kadar albumin serum (p=0,008), penurunan kesadaran saat masuk (p=0,001) dan riwayat stroke (p=0,001) yang memiliki hubungan independen dengan SSGM. Simpulan penelitian ini terdapat korelasi positif antara kadar albumin serum dengan SSGM pada penderita stroke iskemik akut dengan kekuatan korelasi sedang, sehingga semakin rendah kadar albumin serum maka semakin rendah pula SSGM.

Stroke or brain attack is a sudden neurological deficit in central nervous system caused by an ischemic or hemorrhagic incident. Serum albumin level has been known as an indicator of individual health condition. Moderate to very low serum albumin level has been associated with morbidity and all-cause mortality in adults. This research is to assess the correlation between serum albumin level and neurological deficit in acute ischemic stroke patients. The method in this study uses cross-sectional study design. Study subjects are patients treated in Stroke Unit and Neurological ward of Dr. Sardjito hospital Yogyakarta, diagnosed as acute ischemic stroke based on history, clinical examination and head-CT scan according to inclusion criteria. Age, gender, education level, serum albumin level, smoking status, blood glucose level, DM, stroke, hypertension, heart disease, and early hipodense appearance in head-CT scan were entered in analysis. Correlation between serum albumin level and SSGM were tested with Spearman’s test and linear regression model for multivariate analysis. The results were considered as statistically significant if the p value < 0,05. A total of 82 subjects were participated in the study. Analysis results indicated that albumin level is significantly correlated with SSGM (r=0,405; p=0,001). other variables that significantly correlated with SSGM were gender, history of heart disease, decreased consciousness, history of stroke, lesion site, body temperature, blood glucose, ureum level, total protein level, leukocyte count, and potassium level. After multivariate analysis, only serum albumin level (p=0,008), decreased consciousness at arrival (p=0,001), and history of stroke (p=0,001) that have independent correlation with SSGM. Conclusion of this study there was a positive correlation between serum albumin level and SSGM in acute ischemic stroke patients with moderate correlation strength. Hence, the lower serum albumin level, the lower SSGM.

Kata Kunci : Stroke iskemik,Albumin serum,Skala stroke Gadjah Mada,Korelasi