KORELASI GAMBARAN RADIOGRAFI TORAKS PNEUMONIA COVID-19 TERHADAP RASIO PLATELET-LIMFOSIT

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

2022 | Tesis-Spesialis | RADIOLOGI

Latar Belakang dan Tujuan. Kasus COVID-19 di Indonesia semakin meningkat. Banyak kasus tidak dapat dievaluasi dengan CT (computed tomography) toraks resolusi tinggi. Radiografi toraks lebih banyak tersedia dan lebih portabel. Diperlukan biomarker yang andal dan tepercaya untuk memprediksi tingkat keparahan pneumonia COVID-19. Diketahui bahwa rasio Platelet-Limfosit merupakan prediktor potensial pneumonia pada pasien COVID-19. Tujuan dari penelitian ini adalah untuk mengetahui korelasi antara evaluasi foto toraks pneumonia COVID-19 dengan rasio Platelet-Limfosit. Bahan dan Metode. Penelitian cross-sectional retrospektif dengan data sekunder dari hasil radiografi toraks COVID-19 di RSUD Dr. Sardjito Yogyakarta pada bulan Januari 2021 – Juli 2021. Analisis Brixia score pada radiografi toraks pneumonia tipikal COVID-19 dan nilai rasio Platelet-Limfosit . Data dianalisis dengan uji ICC (Intraclass Correlation Coefficient) dan dilanjutkan dengan uji Spearman's rho Hasil. Hasil analisis menunjukkan reliabilitas cukup baik dengan nilai r = 0,983 dan p<0,001 serta 95% CI 0,936-0,995. Hasil uji normalitas (Shapiro-Wilk) menunjukkan bahwa rasio Platelet-Limfosit tidak terdistribusi normal sehingga digunakan analisis uji Spearman's rho. Dari hasil uji signifikansi didapatkan nilai p=0,001 dan r sebesar 0,484 yang berarti terdapat korelasi yang cukup kuat dan bermakna secara statistik antara Brixia score dengan rasio Platelet-Limfosit. Analisis antara Brixia score dengan outcome menunjukkan bahwa Brixia score memiliki kemampuan diskriminasi yang lebih baik dibandingkan rasio Platelet-Limfosit dalam memprediksi kematian. Kesimpulan. Terdapat korelasi yang cukup kuat dan bermakna secara statistik antara Brixia score dengan rasio Platelet-Limfosit (p=0,001) dengan koefisien korelasi (r) sebesar 0,484. Brixia score memiliki kemampuan diskriminasi yang lebih baik daripada rasio Platelet-Limfosit dalam memprediksi kematian dari hasil analisis kurva ROC.

Background and Purpose. The incidence of COVID-19 in Indonesia is increasing. Many cases cannot be evaluated with high-resolution thoracic CT (computed tomography). Thoracic radiography is more widely available and more portable. A reliable and trusted biomarker is needed to predict the severity of COVID-19 pneumonia. It is known that the Platelet-Lymphocyte ratio is a potential predictor of pneumonia in COVID-19 patients. The purpose of this study was to determine the correlation between the evaluation of chest radiographic images of COVID-19 pneumonia and the Platelet-Lymphocyte ratio. Materials and Methods. Retrospective cross-sectional study with secondary data from the results of a COVID-19 chest radiograph at Dr. Sardjito Yogyakarta in January 2021 – July 2021. Analysis of the Brixia score on chest radiograph pneumonia typical of COVID-19 and Platelet-Lymphocyte ratio values. Data were analyzed with the ICC (Intraclass Correlation Coefficient) test and continued with the Spearman's rho test Results. The results of the analysis show that the reliability is quite good with a value of r = 0.983 and p <0.001 and 95% CI 0.936-0.995. The results of the normality test (Shapiro-Wilk) showed that the Platelet-Lymphocyte ratio was not normally distributed so the Spearman's rho test analysis was used. From the results of the significance test, it was found that the value of p=0.001 and r was 0.484, which means that there is a fairly strong and statistically significant correlation between the Brixia score and the Platelet-Lymphocyte ratio. Analysis between the Brixia score and the outcome showed that the Brixia score had a better discriminating ability than the Platelet-Lymphocyte ratio in predicting death. Conclusion. There is a fairly strong and significant correlation between the Brixia score and the Platelet-Lymphocyte ratio (p=0.001) with a correlation coefficient (r) of 0.484. Brixia score has better discrimination ability than Platelet-Lymphocyte ratio in predicting death from the results of ROC curve analysis.

Kata Kunci : COVID-19, Computed tomography, radiografi toraks, Brixia Score, rasio Platelet-Lymphocyte