PENGARUH STATUS GIZI TERHADAP KESINTASAN PADA ANAK LEKEMIA LIMFOBLASTIK AKUT DI RSUP DR SARDJITO

HAFIIDHATURRAHMAH, dr. Eddy Supriyadi, PhD,Sp.A (K).; dr. Neti Nurani, M.Kes, SpA (K)

2019 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar belakang: Malnutrisi pada pasien lekemia limfoblastik akut (LLA) dapat mempengaruhi kesintasan pasien berupa kejadian meninggal. Tujuan: Mengetahui pengaruh status gizi terhadap kesintasan pada pasien LLA Metode: Studi kohort retrospektif pada pasien usia 0- 18 tahun yang terdiagnosis serta menjalani pengobatan LLA di RSUP Dr. Sardjito Yogyakarta dari 1 Januari 2013 hingga 31 Desember 2018. Analisis bivariat dan multivariat dengan Cox regression interval kepercayaan 95% dengan tingkat kemaknaan statistik p < 0,05. Hasil: Total didapatkan 409 subyek, 37 pasien dieksklusi. Dari 372 subyek penelitian didapatkan 262 gizi baik (70,4%) dan 110 malnutrisi (29,6%) berdasarkan BB/TB dan IMT/usia dari World Health Organization (WHO). Kesintasan LLA adalah 52,5+-7,2%. Kesintasan LLA berdasarkan status gizi adalah 55,9+-8,3% pada gizi baik dan 38,7+-1,7% pada malnutrisi. Analisis multivariat didapatkan variabel yang bermakna adalah status gizi malnutrisi p 0,017 (HR 1,7, 95%IK=1,10-2,64) dan stratifikasi risiko tinggi p 0,038 (HR 1,8, 95%IK=1,03-3,12). Kesimpulan: Malnutrisi berpengaruh signifikan menurunkan kesintasan pada pasien lekemia limfoblastik akut.

Background: Nutritional status predicted affects the survival of children with acute lymphoblastic leukemia (ALL). Malnutrition patients experienced lower survival than good nutritional patients. Objective: This study was aimed to know the effect of nutritional status on survival rate in children with acute lymphoblastic leukemia at Sardjito Hospital. Methods: A retrospective cohort study was conducted. We evaluated of medical record of ALL patients aged 0-18 years, from January 1st 2013 to December 31th 2018. Univariate Cox regression was performed for bivariate and multivariate. The relationship between variables was presented as hazard ratio (HR), confidence intervals 95%, and statistical significance levels p <0.05. Result: Total 409 subjects joined the study, 37 subject were excluded. From 372 subjects, 262 subjects (70,4%) was good nutrition status and 110 malnutrition (29,6%) using weight for height (WHZ) and BMI/Z from World Health Organization. Survival rate of ALL is 52,5+- 7,2%. Survival rate of ALL based on nutritional status for good nutrition and malnutrition were 55,9+-8,3% and 38,7+-1,7% respectively. Multivariate analysis showed significant variable were nutritional status of malnutrition (p 0,017,HR 1,7, CI 95%=1,10-2,64), and stratification of high risk (p0,038, HR 1,8, CI 95%=1,03-3,12). Conclusion: Malnutrition decreased significantly survival rate in acute lymphoblastic leukemia.

Kata Kunci : lekemia limfoblastik akut, kesintasan, status gizi, malnutrisi, anak, acute lymphoblastic leukemia, survival rate, nutritional status, malnutrition, children