Perbedaan Outcome Fungsional Pasien Stroke Berdasarkan Nilai Indeks Barthel antara Pasien Stroke dengan Faktor Risiko DM dengan Non DM

ZUNI TRIYANTI, Dr. dr. Ismail Setyopranoto, Sp.S (K); dr. Abdul Ghofir, Sp.S (K)

2015 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Stroke merupakan penyebab kecacatan dan kematian terbesar di dunia, baik di negara berpenghasilan rendah, sedang maupun tinggi yang dapat ditemukan pada semua golongan usia. Diabetes merupakan faktor risiko utama perkembangan stroke, dimana komplikasinya dapat menyebabkan perburukan berupa kecacatan dan kematian. Meskipun demikian, masih terjadi kontroversi perbedaan outcome stroke diantara subjek dengan faktor risiko diabetes dan non diabetes. Beberapa penelitian yang telah dilakukan menemukan hasil yang berbeda dan tidak signifikan. Sementara pengetahuan mengenai hal tersebut sangat penting untuk mekanisme pencegahan stroke dan mengontrol outcome stroke. Tujuan: Mengetahui perbedaan outcome fungsional pasien stroke berdasarkan nilai Indeks Barthel antara pasien stroke dengan faktor risiko diabetes melitus dan non diabetes melitus. Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan rancangan studi potong lintang. Subjek penelitian yang digunakan berupa data rekam medis pasien stroke RSUP Dr. Sardjito yang diambil secara acak, yang telah memenuhi kriteria inklusi dan eksklusi. Penilaian dilakukan dengan membandingkan outcome fungsional pasien stroke berupa tingkat ketergantungan activies of daily living (ADL) berdasarkan nilai Indeks Barthel antara pasien stroke dengan faktor risiko DM dan non DM menggunakan analisis statistik non parametrik Mann-Whitney dan Kruskall Wallis. Hasil: Terdapat 100 subjek penelitian, 50 orang dengan diabetes melitus (50%) dan 50 orang tanpa diabetes melitus (50%). Pada kelompok diabetes, 8 subjek memiliki tingkat ketergantungan ADL total (8%), 36 subjek ketergantungan ADL berat (36%), 5 subjek ketergantungan ADL sedang (5%), 1 subjek ketergantungan ADL ringan (1%) dan 0 subjek memiliki ketergantungan ADL minimal (0%). Pada kelompok non diabetes, 8 subjek memiliki tingkat ketergantungan ADL total (8%), 30 subjek ketergantungan ADL berat (30%), 10 subjek ketergantungan ADL sedang (10%), 2 subjek ketergantungan ADL ringan (2%) dan 0 subjek memiliki ketergantungan ADL minimal (0%). Hasil uji komparatif menggunakan analisis statistik non parametrik Mann-Whitney menunjukkan bahwa secara statistik tidak terdapat perbedaan outcome fungsional pasien stroke yang bermakna berdasarkan nilai Indeks Barthel antara pasien stroke dengan faktor risiko DM dan non DM (P=0,301). Kesimpulan: Tidak terdapat perbedaan outcome fungsional pasien stroke yang bermakna berdasarkan nilai Indeks Barthel antara pasien stroke dengan faktor risiko DM dan non DM. Kata Kunci: Outcome fungsional, stroke, Indeks Barthel, diabetes melitus

Background: Stroke is the most common cause of morbidity and mortality in the world and can be found at any level of age. Diabetes mellitus is a well-established independent risk factor for stroke. Its complications are assosiated with poor outcome of stroke, both disability and mortality. Few studies have been done to assess the difference outcome between stroke patient with diabetes and without diabetes, but their findings are inconsistent. Whereas, the study is important for preventive mechanism and controls stroke outcome. Objective: To assess the differences in the functional outcome of stroke in stroke patient with diabetes and without diabetes according to Barthel Index score. Methods: The study was an observasional study with cross sectional design. Data were obtained from medical record’s stroke patient in the Dr. Sardjito hospital that have been fulfilled the inclusion and exclusion criteria. Differences in functional outcome of stroke patient in the form of dependency level of activities of daily living (ADL) in stroke patient with diabetes and without diabetes was analyzed by Mann-Whitney and Kruskall Wallis analysis. Results: There were 100 subject in this study, 50 subject with diabetes (50%) and 50 subject without diabetes (50%). In diabetic stroke patient, there were 8 subject who had total ADL dependency (8%), 36 subject who had severe ADL dependency (36%), 5 subject (who had moderate ADL dependency 5%), 1 subject who had mild ADL dependency (1%) and 0 subject who had minimal ADL dependency (0%). In nondiabetic stroke patient, there were 8 subject who had total ADL dependency (8%), 30 subject who had severe ADL dependency (30%), 10 subject who had moderate ADL dependency (10%), 2 subject who had mild ADL dependency (2%) and 0 subject who had minimal ADL dependency (0%). Mann-Whitney analysis showed no significant differences in the functional outcome of stroke between stroke patient with diabetes and without diabetes according to Barthel Index score (P=0,301). Conclusion: There is no difference functional outcome of stroke between stroke patient with diabetes and without diabetes according to Barthel Index score. Keywords: Functional outcome, stroke, Barthel Index, diabetes mellitus.

Kata Kunci : Outcome fungsional, stroke, Indeks Barthel, diabetes melitus