KORELASI SATURASI OKSIGEN TERHADAP GAMBARAN RADIOGRAFI TORAKS PNEUMONIA COVID-19

TRIANINGSIH, Dr. dr. Bagaswoto P., Sp.Rad (K), Sp.KN, M.Kes, FICA.; dr. Sri Retna Dwidanarti, Sp.Rad (K)Onk

2021 | Tesis-Spesialis | RADIOLOGI

Latar belakang: Kasus pneumonia COVID-19 terus meningkat. Diketahui bahwa hipoksemia merupakan salah satu faktor prediktor kematian. Hipoksemia dapat dideteksi dini dengan pengukuran saturasi oksigen. Tujuan penelitian: Mengetahui korelasi saturasi oksigen terhadap gambaran radiografi toraks pneumonia COVID-19. Bahan dan Cara: Penelitian ini adalah penelitian observasional analitik korelasi cross- sectional dengan data sekunder secara consecutive nonrandom sampling. Subjek penelitian adalah semua pasien COVID-19 dengan hasil PCR positif dengan gambaran pneumonia typical yang dilakukan pemeriksaan saturasi oksigen perifer dan saturasi oksigen arterial dengan rentang waktu dengan pemeriksaan foto toraks kurang dari 4 jam di RSUP Dr Sardjito dengan periode Juni -Juli 2021. Dilakukan penilaian foto toraks dengan sistem Brixia Score dengan nilai Brixia Score 0-18. Hasil saturasi oksigen perifer yang didapatkan dari pulse oxymetri dan saturasi oksigen arterial didapatkan dari analisa gas darah dikorelasikan dengan nilai Brixia Score dengan uji korelasi. Hasil: didapatkan subjek 43 penelitian yang memenuhi kriteria inklusi dan eksklusi penelitian. Dari 43 subjek penelitian didapatkan jenis kelamin laki-laki lebih banyak yaitu 26 subjek (60,5%), perempuan 17 subjek (39,5%). Dengan sebaran usia <30 tahun sebanyak 2 subjek (4,7%), 31-40 tahun sebanyak 6 subjek (14%), 41-50 tahun sebanyak 10 subjek (23,3%) dan yang paling banyak adalah usia >50 tahun yaitu sebanyak 25 subjek (58,1%). Untuk hasil luaran didapatkan 30 subjek sembuh (69,8%), yang meninggal 8 subjek (18,6%) dan tidak didapatkan data sebanyak 5 subjek (11,6%). Untuk nilai mean Brixia score didapatkan 10,139 - 3,427, dan nilai mean SpO2 86,093 -­ 8,026 serta nilai mean SaO2 93,500 - 7,454. Didapatkan korelasi antara saturasi oksigen SpO2 dengan Brixia Score dengan nilai P = 0,000. Nilai r negatif artinya semakin tinggi nilai SpO2 maka semakin rendah nilai Brixia Score. Dari hasil perhitungan dapat diketahui bahwa besar koefisien korelasi (r) antara SpO2 dengan Brixia score adalah sebesar 0,005 dengan signifikansi didapati nilai p=0,976 yang berarti bahwa tidak terdapat korelasi yang bermakna secara statistik antara SaO2 dengan nilai Brixia score. Kesimpulan : Terdapat korelasi yang bermakna secara statistik antara nilai saturasi oksigen perifer (SpO2) dengan Brixia score pada pasien COVID-19 (p=0,000) dengan nilai koefisien korelasi (r) sebesar -0,653 yang berarti berkorelasi kuat dengan arah korelasi negatif, semakin tinggi Brixia score semakin rendah nilai saturasi oksigen. Tidak terdapat korelasi antara SaO2 dengan Brixoa Score. Terdapat discrepancy antara SaO2 dengan SpO2.

Background: COVID-19 pneumonia cases continues to increase. It is known that hypoxemia is a predictor of mortality. Hypoxemia can be detected early by measuring oxygen saturation. Objective: To determine the correlation of oxygen saturation to the chest radiographic picture of COVID-19 pneumonia. Materials and Methods: This study was a cross-sectional correlation analytic observational study with secondary data using consecutive nonrandom sampling. The subjects of the study were all COVID-19 patients with positive PCR results with a typical pneumonia picture who were examined for peripheral oxygen saturation and arterial oxygen saturation with a time span with a chest x-ray examination of less than 4 hours at Dr Sardjito Hospital with the period June-July 2021. An assessment was carried out chest X-ray with the Brixia Score system with a Brixia Score 0-18. Peripheral oxygen saturation results obtained from pulse oximetry and arterial oxygen saturation obtained from blood gas analysis were correlated with the Brixia Score value by correlation test. Results: 43 research subjects met the inclusion and exclusion criteria of the study. Of the 43 research subjects, there were more men, namely 26 subjects (60.5%), female 17 subjects (39.5%). With the distribution of age <30 years as many as 2 subjects (4.7%), 31-40 years as many as 6 subjects (14%), 41-50 years as many as 10 subjects (23.3%) and most of them are aged >50 years. namely as many as 25 subjects (58.1%). For the outcome, 30 subjects recovered (69.8%), 8 subjects died (18.6%) and there were no data obtained for 5 subjects (11.6%). The mean Brixia score was 10.139 3,427, and the mean SpO2 was 86,093 8,026 and the mean SaO2 was 93,500 7,454. A correlation was found between SpO2 oxygen saturation and Brixia Score with P value = 0.000. A negative r value means that the higher the SpO2 value, the lower the Brixia Score. From the calculation results, it can be seen that the correlation coefficient (r) between SpO2 and Brixia score is 0.005 with a significance value of p=0.976, which means that there is no statistically significant correlation between SaO2 and the Brixia score. Conclusion: There is a statistically significant correlation between peripheral oxygen saturation (SpO2) and Brixia scores in COVID-19 patients (p=0.000) with a correlation coefficient (r) of -0.653, which means a strong correlation with a negative correlation direction, the higher The Brixia score the lower the oxygen saturation value. There is no correlation between SaO2 and Brixia Score. There is a discrepancy between SaO2 and SpO2.

Kata Kunci : Pneumonia COVID-19, Brixia Score, radiografi toraks, Pneumonia COVID-19, Brixia Score, chest radiograph