KORELASI KADAR VITAMIN D DENGAN DERAJAT KEPARAHAN SEPSIS BERDASARKAN SKOR SOFA

MEDICIA YURISTA, dr. Rizka Humardewayanti Asdie, SpPD-KPTI.; dr. Deshinta Putri Mulya, SpPD-KAI

2021 | Tesis-Spesialis | ILMU PENYAKIT DALAM

Latar Belakang: Sepsis merupakan suatu kondisi disfungsi organ yang mengancam jiwa. Derajat keparahan sepsis direpresentasikan dengan peningkatan skor Sequential (sepsis-related) Organ Failure Assessment (SOFA). Vitamin D diketahui berperan dalam sistem imun alami dan imun adaptif. Insufisiensi Vitamin D dikaitkan dengan keparahan sepsis yang dinilai berdasarkan skor SOFA Tujuan Penelitian: Untuk mengetahui korelasi antara kadar vitamin D dengan derajat keparahan sepsis berdasarkan skor SOFA. Metode Penelitian: Observasional dengan desain penelitian cross-sectional. Dari 59 subjek sepsis yang telah menandatangani informed concent dilakukan pengambilan darah skor SOFA dan pemeriksaan kadar vitamin D. Penelitian dilakukan bulan Desember 2018-Oktober 2019. Hubungan kadar vitamin D dengan skor SOFA dalam penelitian ini dianalisis menggunakan uji korelasi spearman. Subyek dilakukan subanalisis menggunakan Mann Whitney Test untuk mengetahui perbedaan median skor SOFA pada kelompok defisiensi/insufisiensi dan sufisien. Hasil Penelitian: Dari 59 pasien sepsis yang terlibat dalam penelitian ini, yang termasuk dalam kategori vitamin D defisiensi/insufisiensi sebanyak 55 subyek (93,2%) dan sufisien 4 subyek (6,8%). Hasil uji korelasi spearman didapatkan hasil r = -0,246 dan p = 0,030 menunjukkan bahwa semakin tinggi kadar vitamin D maka semakin membaik keparahan sepsis (skor SOFA semakin rendah) dan bermakna secara statistik (p <0,05). Hasil sub analisis dengan Mann Whitney Test kelompok defisiensi/insufisien dan sufisien berturut turut memiliki median skor SOFA 8,0 dan 5,0 dengan p 0,048, secara statistik bermakna. Kesimpulan: Terdapat korelasi negatif antara kadar vitamin D dengan derajat keparahan sepsis berdasarkan skor SOFA

Background: Sepsis is a potentially life-threatening condition. Severity of sepsis is represented by the increasing number of Sequential (sepsis-related) Organ Failure Assessment (SOFA) score. Vitamin D has roles in innate and adaptif immunity. Vitamin D insufficiency is associated with severity of sepsis. Objective: To determine whether there is a correlation between vitamin D (25 (OH) D) levels and severity of sepsis based on SOFA score Research method: Observational with cross-sectional research design from December 2018-October 2019. We included 38 subjects that signed the informed concent. Blood sampling of SOFA score and vitamin D was taken after the patients diagnosed sepsis. The analysis of correlation between SOFA score and vitamin D level used SPSS with Spearman test. The research is further subanalyzed by Mann Whitney test to know the median difference between defficiency/insufficiency and sufficient vitamin D group and its significancy (p value). Results: The subjects of vitamin D defficiency/insufficiency group is 34 subjects (89.5%) and sufficient group is 4 subjects (10.5%). The correlation test by Spearman test showed r = -0.592 and p = 0.00 (signifficant if p<0.05). This result means that the higher level of vitamin D, the better severity of sepsis (lower SOFA score) and statistically signifficant (p <0.05). The result of sub analysis with Mann Whitney test, on defficient/insufficient vitamin D group compares with sufficient group, the SOFA score median respectively 8.0 and 5.0, p 0.048 (statistically signifficant if p <0.05). Conclusion: There is negative correlation between vitamin D and severity of sepsis based on SOFA score.

Kata Kunci : skor SOFA, Sepsis, vitamin D, SOFA score