Korelasi antara jumlah neutrofil dengan revised trauma score pada cedera kepala

PERBOWO, Mecca Mulyo, dr. Indarwati Setyaningsih, Sp.S(K)

2010 | Tesis |

Latar belakang: Cedera kepala merupakan masalah kesehatan utama yang menjadi penyebab kematian dan kecacatan. Cedera kepala mengakibatkan meningkatnya kadar katekolamin dalam darah yang memacu pelepasan neutrofil ke dalam darah. Tujuan: untuk mengetahui korelasi jumlah neutrofil terhadap nilai RTS pada penderita cedera kepala. Metode: Penelitian ini merupakan penelitian observasional analitik dengan menggunakan rancangan cross-sectional. Subjek pada penelitian ini adalah penderita cedera kepala yang dirawat di RSUP Dr. Sardjito yang memenuhi kriteria. Data tentang jumlah neutrofil, umur, jenis kelamin, reaksi pupil, kelainan CT scan kepala, onset cedera kepala, kejang, tekanan darah, nadi, frekuensi nafas, suhu dinilai dan dibandingkan dengan outcome cedera kepala dalam nilai RTS. Hasil: Tiga puluh penderita cedera kepala ikut serta dalam penelitian ini. Dari uji korelasi Spearman diketahui bahwa terdapat hubungan yang bermakna antara jumlah neutrofil dengan RTS (=-0,392; p=0,032). Selain itu, CT scan kepala (r=0,542;p=-0,002), nadi (r=0,550;p=- 0,002), angka leukosit (r=-0,559;p=0,001) dan limfosit (r=0,498;p=0,005) juga memiliki hubungan bermakna dengan RTS. Setelah dilakukan analisis multivariat dengan uji regresi linier, hanya nadi yang memiliki hubungan bermakna terhadap RTS (r=-2,336;p=0,026;CI=- 0,068 Ö¾ -0,005) yang hubungan independen dengan RTS, sedangkan neutrofil tidak lagi berhubungan bermakna dengan RTS. Kesimpulan: Terdapat korelasi negatif antara jumlah neutrofil dengan Revised Trauma Score pada penderita cedera kepala dengan kekuatan korelasi lemah, sehingga semakin tinggi jumlah neutrofil maka semakin rendah nilai RTS.

Background: head injury is a major health problem worldwide, as it cause morbidity and mortality. Head injury increase the catecholamine level in the blood, which in turn promote the neutrophil release into the blood. Objective: to assess the correlation between neutrophil count and RTS score in patients with head injury. Method: this is an observational study with cross-sectional design. The subjects were head injury patients treated in Dr. Sardjito hospital according to the criteria. Patient’s data consisted of neutrophil count, age, gender, pupil reaction, head-CT scan abnormality, head injury onset, seizure, blood pressure, pulse rate, respiratory rate, body temperature, and all these variable were then compared with outcome of head injury measured with RTS. Result: 30 patients with head injury were included in the study. From Spearman’ correlation test, it was shown that neutrophil were significantly correlated with RTS (=-0,392; p=0,032). Moreover, head-CT scan (r=0,542;p=-0,002), pulse rate (r=0,550;p=-0,002), leukocyte count (r=-0,559;p=0,001) and lymphocyte count (r=0,498;p=0,005) were also significantly correlated with RTS score. After multivariate analysis with linear regression test, only pulse rate still had significant and independent correlation with RTS score (r=-2,336;p=0,026;CI=- 0,068 ־ -0,005). Meanwhile, neutrophil were no longer had association with RTS score. Conclusion: there was a weak negative correlation between neutrophil count and Revised Trauma Score in patients with head injury, thus as the neutrophil count increase, RTS score would decrease.

Kata Kunci : Neutrofil,Resived trauma score,Cedera kepala, neutrophil count, revised trauma score, head injury