KORELASI ANTARA LINGKAR LENGAN ATAS (LiLA) DENGAN SKOR MODIFIED TRUELOVE WITTS SEVERITY INDEX (MTWSI) STUDI PADA PASIEN KOLITIS ULSERATIF

AGUS GIYARTO, Dr.dr. Neneng Ratnasari, SpPD-KGEH.; dr. Putut Bayu Purnama, SpPD-KGEH.

2016 | Tesis-Spesialis | SP Ilmu Penyakit Dalam

Latar belakang: Kolitis ulseratif merupakan inflamasi mukosa diffuse terbatas pada kolon. Skor Modified Truelove Witts Severity Index (MTWSI) digunakan untuk menilai indeks aktifitas Kolitis Ulseratif. Durasi, aktifitas dan area keterlibatan kolitis ulseratif mempengaruhi beratnya malnutrisi. Lingkar lengan atas (LiLA) memberikan gambaran tentang keadaan jaringan otot dan lapisan lemak bawah kulit merupakan parameter antropometri yang sangat sederhana dan mudah dilakukan. Indeks masa tubuh (IMT) memiliki korelasi yang sangat kuat dengan LiLA. Tujuan: Untuk mengetahui apakah terdapat korelasi negatif antara Lingkar Lengan Atas (LiLA) dengan Skor Modified Truelove Witts Severity Index (MTWSI) pada pasien Kolitis Ulseratif. Metode:Penelitian ini merupakan suatu penelitiancross-sectional.Penelitian ini melibatkan pasien-pasien dengan kolitis ulseratifdi Poliklinik Gastroenterohepatologi Rumah Sakit Dr. Sardjito Yogyakarta pada bulan Mei 2015 sampai dengan bulan Mei 2016.Semua pasien menjalani pengukuran LiLA dan skor MTWSI. Variabel bebas adalah skor MTWSI dan variabel terikat adalah LiLA. Hasil: Padapenelitian ini terdapat 35 pasien Kolitis Ulseratif. Proporsi subyek lakilaki 21 orang (60.0%) dan perempuan 14 orang (40.0%), rerata usia 49.40+-14,30 tahun, rerata indeks massa tubuh (IMT) sebesar 21.02+-4.02 kg/m-persegi. Rerata durasi kolitis 19.41+-23.02 bulan. Medianskore MTWSI adalah 6.00 (2-12), sebanyak 4(11.4%) dalam fase remisi, 31(88.5%) fase aktif, ringan 25(71.4 %), sedang 6(17.1%). Rerata LiLA 23.82+-3.09 cm, berdasar ukuran LiLAmalnutrisi sebanyak 16(45.7%),non malnutrisi sebanyak 19(54.3%), berdasar IMT malnutrisi sebanyak 8(22.9%), non malnutrisi sebanyak 27(77.1%). Terdapat korelasi negatif bermakna antara skore MTWSI dengan nilai LiLA (r= -0,512, p<0,01),terdapat perbedaan bermakna skore MTWSI antara non malnutrisi dan malnutrisi, p<0,01.

Background: Ulcerative Colitis is a diffuse mucosal inflammation limited to the colon. Modified Truelove Witts Severity Index Score (MTWSI) is used to assess the Ulcerative Colitis activity index. Duration, activity and engagement area of Ulcerative Colitis affect the severity of malnutrition. Middle upper arm circumference (MUAC) which provides an overview of the state of muscle tissue and subcutaneous fat layer is an anthropometric parameter,simple and easy to perform. Body mass index (BMI) has a very strong correlation with MUAC. Objective: To determine whether there is a negative correlation between the Middle Upper Arm Circumference (MUAC) with Modified Truelove Witts Severity Index Score (MTWSI) in Patients with Ulcerative Colitis. Methods: This study is a cross-sectionalstudy which involved patients with UlcerativeColitis at Gastroenterohepatology Polyclinic Hospital Dr. Sardjito from May 2015 until May 2016. All patients underwent measurement of MUAC and MTWSI score. The independent variable is MTWSI score and the dependent variable was MUAC. Results:There were 35 patients with Ulcerative Colitis. The proportion of male subjects was 21(60.0%) and of female subjects 14(40.0%) , mean age 49.40+-14.30 years, mean body mass index (BMI) at 21.02+-4.02 kg/m. The mean duration of Colitis was 19.41+-23.02 months. MTWSI score median was 6.0(2-12), total of 4(11.4%) in remission phase, 31(88.5%) in the active phase, mild 25(71.4%), moderate 6(17.1%). MUAC mean 23.82+-3.09cm, malnutrition based on MUAC was 16(45.7%), non malnutrition was 19(54.3%), based on the IMT malnutrition was 8(22.9%), non malnutrition was 27(77.1%). There was a significant negative correlation between scores of MTWSI with MUAC values (r = -0.512, p<0.01), there were significant differences in scores of MTWSI between non malnutrition and malnutrition, p<0.01. Conclusion: There was a significant negative correlation between the Upper Arm Circumference (MUAC) with a Modified Truelove Witts Severity Index (MTWSI) Score in Patients with Ulcerative Colitis.

Kata Kunci : Ulserative Colitis - MUAC- MTWSI