Nilai Prognostik Parameter Fibrinogen dan Uji Reliabilitas terhadap Outcome Stroke Iskemik Akut

Abstract

Nilai Prognostik Parameter Fibrinogen dan Uji Reliabilitas terhadap Outcome Stroke Iskemik Akut

Abstrak: Fibrinogen merupakan protein fase akut dimana kadarnya akan meningkat sebagai respon terhadap terjadinya infeksi, peradangan, stress, tindakan bedah, trauma dan nekrosis jaringan, akibat peningkatan kadar fibrinogen ini akan menyebabkan peningkatan viskositas plasma dan peningkatan aggregasi trombosit serta aggregasi eritrosit. Fibrinogen pada stroke iskemik akut dijumpai kadarnya akan meningkat terutama pada pria, usia muda dan genetik. Tujuan penelitian ini adalahuntuk melihat nilai rata-rata kadar fibrinogen plasma dan kesepakatan penilaian outcome pada dua pengamat.Metode Penelitian ini adalah studi rancangan kohort yangdilakukan sejak April 2013 hingga Agustus 2013 di Rumah Sakit Umum Adam Malik Medan. Dilakukan pemeriksaan darah rutin di instalasi gawat darurat (IGD) dan pengukuran kadar fibrinogen dengan mengunakan metode Clauss.Outcome stroke diukur dengan menggunakan Modified Ranking Scale (mRS).Analisa statistik dilakukan secara bivariat dengan menggunakan uji Wilcoxon. Dari136 pasien stroke iskemik akut yang diteliti, diperoleh seimbang kelompok usia muda dan usia tua sebanyak 50%. Perempuan lebih banyak dari laki-laki sebanyak 55.1%. Nilai rerata umur subyek penderita stroke iskemik akut pada penelitian sekitar 56.85 ( SE 1.123); dengan umur terendah 24 tahun dan tertinggi umur 84 tahun.Nilai reliabilitas kappa yang dilakukan pada dua pengamat adalah 0,566 yang artinya dijumpai moderate agreement pada kedua pengamat.Terdapat perbedaan yang bermakna antara hari pertama kadar fibrinogen plasma sebelum pemakaian aspirin dan hari ke sembilan puluh setelah pemakaian aspirin ( p< 0,005).

Kata kunci: fibrinogen, fase akut stroke iskemik, outcomestroke

Prognostic Value of Fibrinogen and Reliability Test of Acute Ischemic Stroke Outcome

Abstract: Fibrinogenis an acute phase protein which levels will rise in response to infection, inflammation, stress, surgery, trauma and tissue necrosis, due to an increase in the fibrinogen level will cause an increase in plasma viscosity and increased platelet aggregation and erythrocytea ggregation. Fibrinogen in acute iscemic stroke found levels will rise, especially in men, young age and genetic. The objective of this research was to see the average value of plasma fibrinogen levels and outcome assessment agreement on two observers. Cohort design study was conducted from April 2013 to August 2013 at the Adam Malik General Hospital. Routine blood examination in emergency department (ED)instalation and measured levels of fibrinogen using the Clauss method. Outcome of stroke was measured using the modified Ranking Scale (MRS). Bivariate statistical analyzes were performed using the Wilcoxon test. There are 136 acute ischemic stroke patients studied obtained a balanced group of young and old age as much as 50%. More women than men as much as 55.1%. Mean age value of the subject of acute ischemic stroke patients in the study approximately 56.85 (SE 1,123), with the lowest age of 24 years and age 84 years. Highest value of reliability kappa conducted on two observers was 0.566, which means moderate agreement found in both observers. There was difference significantly between the first day of plasma fibrinogen levels before the used of aspirin and ninety days after the used of aspirin (p <0.005).

Keyword: fibrinogen, acute phase of iscemic stroke, outcome stroke