Peran Pola Makan Dengan Kandungan Tinggi Lemak Pada Kejadian Stroke Hemoragik di RSUD Tgk Chik Ditiro Sigli

T. JAUHARDIN STB, dr.Rachmat Andi Hartanto,Sp.BS(K); dr.Endro Basuki,M.Kes,Sp.BS(K); Dr.dr.Ismail Setyopranoto,Sp.S(K)

2020 | Tesis-Spesialis | BEDAH SARAF

Latar belakang: Perdarahan intraserebral menyumbang ~10% dari semua stroke dan dikaitkan dengan tingginya angka kematian. Provinsi Aceh memiliki prevalensi kejadian stroke sebanyak 6,6 per mil. Pola makan subjek Aceh cenderung tinggi protein, berlemak, dan tinggi kalori tetapi rendah serat menimbulkan ketidakseimbangan asupan zat gizi. Kondisi tersebut merupakan faktor risiko untuk terjadinya stroke hemoragik. Tujuan: Untuk membuktikan peran pola makan dengan kandungan tinggi lemak terhadap kejadian stroke hemoragik di RSUD Tgk Chik Ditiro Sigli. Metode: Observasional analitik dengan rancangan case control. Kasus adalah penderita stroke hemoragik, dan kontrol adalah subjek sehat yang tidak menderita stroke hemoragik serta tidak memiliki faktor risiko hipertensi dan diabetes melitus. Jumlah subjek adalah 136 subjek. Data yang dikumpulkan yaitu identitas sampel, indeks massa tubuh, pola makan, hipertensi, diabetes melitus, aktifitas fisik merokok dan kadar kolesterol. Data pola makan dikumpulkan dengan formulir food frequency qualitatif modifikasi. Hasil penelitian dianalisis dengan menggunakan Chi square, Fisher exact tes dan uji regresi logistik. Hasil: Rata-rata usia subjek penelitian adalah 46,69 tahun (SD + 6,12). Sebanyak 73% subjek penelitian berjenis kelamin laki-laki. Hasil penelitian menunjukkan faktor risiko yang terbukti memiliki hubungan bermakna dengan kejadian stroke hemoragik adalah kurang konsumsi serat (uji wald=5,237; OR=3,61; 95%CI=1,20-10,85; p=0,022), obesitas (uji wald=13,009; OR=9,16; 95%CI=2,75-30,51; p=0,000), merokok (uji wald=8,454; OR=6,31; 95%CI=1,82-21,86; p=0,004), kurang aktifitas fisik (uji wald=10,200; OR=5,53; 95%CI=1,91-15,94; p=0,002), LDL-Kolesterol (uji wald=8,544; OR=8,74; 95%CI=2,04-37,40; p=0,003). Kesimpulan: Terbukti bahwa kurang mengkonsumsi serat, hipertensi, diabetes melitus, obesitas, kurangnya aktivitas fisik, merokok dan kadar LDL-kolesterol berhubungan dengan kejadian stroke hemoragik di RSUD Tgk Chik Ditiro Sigli. Obesitas merupakan faktor risiko yang memiliki pengaruh paling besar pada kejadian stroke hemoragik.

Background : Hemorrhagic stroke contributes about 10% of all strokes incidence with high mortality of the case. The prevalence of stroke incidence in Aceh was 6.6 per mile. The dietary habit of Aceh resident tends to be high fat, high protein, high calories but low fiber, causing an imbalance of nutrition intake. This condition is well known as risk factor hemorrhagic stroke. Aim : To prove the role of high-fat dietary habit to hemorrhagic stroke incidence in RSUD Tgk Chik Ditiro Sigli. Methods : This is an observational analytic research with case control design. The case group is consisted of patients with hemorrhagic stroke and control group is healthy population without hemorrhagic stroke, and no risk factor for hypertension and diabetes type 2. Total subject was 136 subjects. The data that will be gathered in this research including patient identity, body mass index (BMI), dietary habit, physical activity, history of smoking, diabetes type 2, hypertension and cholesterol level. Data of dietary habit was collected by using modified qualitative food frequency form. The result of study were analyzed usinng X2 test, Fisher exact test and logistic regression. Results : The average age subjects of this study was 46.69 years (SD + 6.12). As many as 73% of research subjects were male. The results showed risk factors that were proven to have a significant relationship with the incidence of hemorrhagic stroke at RSUD Tgk Chik Ditiro Sigli were lack of fiber consumption (Wald test = 5.237 with OR = 3.61 (95% CI = 1.20-10.85; p = 0.022), obesity (Wald test = 13,009 with OR = 9.16 (95% CI = 2.75-30.51; p = 0.000), smoking (Wald test = 8.454 with OR = 6.31 (95% CI = 1.82-21.86; p = 0.004), lack of physical activity (Wald test = 10.200 with OR = 5.53 (95% CI = 1.91-15.94; p = 0.002), LDL-cholesterol (Wald test = 8.544 with OR = 8.74 (95% CI = 2.04-37.40; p = 0.003). Conclusion : It was proven that lack of fiber consumption, hypertension, diabetes mellitus, obesity, lack of physical activity, smoking and LDL-Cholesterol levels were associated with the incidence of hemorrhagic strokes at the RSUD Tgk Chik Ditiro Sigli. Obesity is the greatest risk factor that influence on the incidence of hemorrhagic strokes at RSUD Tgk Chik Ditiro Sigli.

Kata Kunci : diet tinggi lemak, stroke hemoragik, faktor risiko stroke, hemorrhagic stroke, high-fat diet, risk factor of stroke