Hubungan antara Hipertensi dan Kadar HbA1c dengan Kejadian Amputasi Ekstremitas Bawah pada Pasien Ulkus Diabetikum

Rafif Ryandra Izdhihar, Safari Wahyu Jatmiko

Abstract


Ulkus diabetikum merupakan komplikasi kronis dari diabetes mellitus (DM). Hipertensi dan kadar HbA1c menjadi faktor dari progresivitas penyakit ini dengan risiko amputasi yang tinggi. Tujuan penelitian ini adalah menganalisis hubungan antara hipertensi dan kadar HbA1c dengan kejadian amputasi ekstremitas bawah pada pasien ulkus diabetikum dengan desain penelitian observasional analitik dan pendekatan case-control. Jumlah subjek penelitian ini sebanyak 116 subjek yang diambil menggunakan teknik consecutive sampling. Data sekunder berupa rekam medis pasien ulkus diabetikum dari RSUD Kota Madiun periode Januari 2022 hingga Juli 2023 digunakan. Hasilnya, pasien ulkus diabetikum dalam penelitian ini mayoritas berusia lanjut (96, 82.8%), perempuan (72, 62.1%), tidak menderita hipertensi (65, 56%), dan kadar HbA1c tidak terkontrol (79, 68.1%). Uji Chi-square menunjukkan adanya hubungan antara hipertensi terhadap amputasi ekstremitas bawah dengan nilai p=0.04 (OR=2.181) dan kadar HbA1c terhadap amputasi ekstremitas bawah dengan nilai p=0.01 (OR=2.904). Analisis regresi logistik menunjukkan nilai p=0.098 (OR=1.919) pada hipertensi dan nilai p=0.018 (OR=2.769) pada kadar HbA1c. Kesimpulannya, ada hubungan yang signifikan antara hipertensi dan kadar HbA1c dengan kejadian amputasi ekstremitas bawah pada pasien ulkus diabetikum.

Keywords


Amputasi Ekstremitas Bawah; HbA1c; Hipertensi; Ulkus Diabetikum

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References


International Diabetes Federation. IDF Diabetes Atlas 10th edition. 2021. Available from: www.diabetesatlas.org

Kementerian Kesehatan RI. Hasil Utama Riskesdas 2018. Jakarta: Kemenkes; 2019.

Kementerian Kesehatan RI. Laporan Provinsi Jawa Timur Riskesdas 2018. Jakarta: Kemenkes; 2019.

Dinas Kesehatan Kota Madiun. Profil Kesehatan Kota Madiun Tahun 2023. Madiun: Dinkes Kota Madiun; 2023.

World Health Organization. Global Report on Diabetes. Geneva: WHO Press; 2016.

Hariftyani AS, Novida H, Edward M. Profile of Diabetic Foot Ulcer Patients at Tertiary Care Hospital in Surabaya, Indonesia. Jurnal Berkala Epidemiologi. 2021;9(3):293–302. Available from: https://doi.org/10.20473/jbe.v9i32021.293-302

Ibrahim AM. Diabetic Foot Ulcer: Synopsis of the Epidemiology and Pathophysiology. International Journal of Diabetes and Endocrinology. 2018;3(2):23–8. Available from: https://doi.org/10.11648/j.ijde.20180302.11

Muhdar R, Siwu J, Katuuk ME. Hubungan Lama Menderita dan Perawatan Kaki Diabetes dengan Resiko Ulkus Kaki Diabetik di Klinik Husada Sario Manado. ejournal Keperawatan. 2018;6(2).

Rina, Setyawan H, Nugroho H, Hadisaputro S, Pemayun TGD. Faktor-Faktor Risiko Kejadian Kaki Diabetik pada Penderita Diabetes Melitus Tipe 2 (Studi Kasus Kontrol di RSUP dr. M. Djamil Padang). Jurnal Epidemiologi Kesehatan Komunitas. 2016;1(2):48–60.

Elghoneimy YA, Alkabah AA, Alalsayedsalih HM, Almanyan AJ, Alibrahim HA, Albokamsin MH, et al. Risk Factors and Surgical Outcomes of Diabetic Foot in Diabetic Patients at King Fahad University Hospital. Cureus. 2022;14(12):e32457. Available from: https://doi.org/10.7759/cureus.32457

Atosona A, Larbie C. Prevalence and Determinants of Diabetic Foot Ulcers and Lower Extremity Amputations in Three Selected Tertiary Hospitals in Ghana. Journal of Diabetes Research. 2019:2019. Available from: https://doi.org/10.1155/2019/7132861

Lin C, Liu J, Sun H. Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A meta-analysis. PLoS ONE. 2020;15(9):e0239236. Available from: https://doi.org/10.1371/journal.pone.0239236

Indranila K. Glycated Hemoglobin A1c as a Biomarker Predictor for Diabetes Mellitus, Cardiovascular Disease and Inflammation. Indonesian Journal of Clinical Pathology and Medical Laboratory. 2017;23(2):191–96.

Oktalia AW, Retnaningrum YR, Khotimah S. Hubungan antara Penyakit Arteri Perifer dan Kadar Hba1c dengan Tindakan Amputasi Ekstremitas pada Pasien Ulkus Kaki Diabetik di RSUD Abdul Wahab Sjahranie Samarinda. Jurnal Sains dan Kesehatan. 2021;3(5):715–21. Available from: https://doi.org/10.25026/jsk.v3i5.641

Din N, Khan M, Khan BD, Ghaffar T, Ikram MT, Aamir MS, et al. Association of Severity of Diabetic Foot Ulcer with Glycated Hemoglobin A1C Levels. Pakistan Journal of Health Sciences. 2023;4(1):161–65. Available from: https://doi.org/10.54393/pjhs.v4i01.497

Moon KC, Kim SB, Han SK, Jeong SH, Dhong ES. Risk Factors for Major Amputation in Hospitalized Diabetic Patients with Forefoot Ulcers. Diabetes Research and Clinical Practice. 2019;158. Available from: https://doi.org/10.1016/j.diabres.2019.107905

Ohishi M. Hypertension with diabetes mellitus: physiology and pathology. Hypertension Research. 2018. Available from: https://doi.org/10.1038/s41440-018-0034-4

Ponirakis G, Petropoulos IN, Alam U, Ferdousi M, Asghar O, Marshall A, et al. Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes. American Journal of Hypertension. 2019;32(8):796–803. Available from: https://doi.org/10.1093/ajh/hpz058

Bondar A, Popa A, Papanas N, Popoviciu M, Vesa C, Sabau M, et al. Diabetic neuropathy: A narrative review of risk factors, classification, screening and current pathogenic treatment options (Review). Experimental and Therapeutic Medicine. 2021;22(1). Available from: https://doi.org/10.3892/etm.2021.10122

Behroozian A, Beckman JA. Microvascular Disease Increases Amputation in Patients With Peripheral Artery Disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2020;40(3):534–540. Available from: https://doi.org/10.1161/atvbaha.119.312859

Pemayun TGD, Naibaho RM, Novitasari D, Amin N, Minuljo TT. Risk factors for lower extremity amputation in patients with diabetic foot ulcers: a hospitalbased case-control study. Diabetic Foot & Ankle. 2015;6. Available from: https://doi.org/10.3402/dfa.v6.29629

Yuzuguldu B, Zengin B, Simsir IY, Cetinkalp S. An Overview of Risk Factors for Diabetic Foot Amputation: An Observational, Single-centre, Retrospective Cohort Study. touchREVIEWS in Endocrinology. 2023;19(1):85–93. Available from: https://doi.org/10.17925/ee.2023.19.1.85

Perng CK, Chou HY, Chiu YJ. Identifying major predictors of lower-extremity amputation in patients with diabetic foot ulcers. Journal of the Chinese Medical Association. 2021;84(3):285–289. Available from: https://doi.org/10.1097/jcma.0000000000000473

Wang M, Hng TM. HbA1c: More than just a number. Australian Journal of General Practice. 2021;50(9):628–32. Available from: https://doi.org/10.31128/ajgp-03-21-5866

Lai YR, Chiu WC, Huang CC, Tsai NW, Wang HC, Lin WC, et al. HbA1C Variability Is Strongly Associated With the Severity of Peripheral Neuropathy in Patients With Type 2 Diabetes. Frontiers in Neuroscience. 2019;13(90). Available from: https://doi.org/10.3389/fnins.2019.00090

Chandra K, Singh P, Dwivedi S, Jain S. Diabetes Mellitus and Oxidative Stress: A Co-relative and Therapeutic Approach. Journal of Clinical and Diagnostic Research. 2019;13(5):BE07-BE12. Available from: https://doi.org/10.7860/jcdr/2019/40628.12878

Akter N. Diabetic Peripheral Neuropathy: Epidemiology, Physiopathology, Diagnosis and Treatment. Delta Medical College Journal. 2019;7(1):35–48. Available from: https://doi.org/10.3329/dmcj.v7i1.40619

Takeda Y, Matoba K, Sekiguchi K, Nagai Y, Yokota T, Utsunomiya K. et al. Endothelial Dysfunction in Diabetes. Biomedicines. 2020. Available from: https://doi.org/10.3390/biomedicines8070182.

Sadriwala QS, Gedam BS, Akhtar MA. Risk factors of amputation in diabetic foot infections. International Surgery Journal. 2018;5(4):1399. Available from: https://doi.org/10.18203/2349-2902.isj20181118

Kusuma IPH, Yasa KP, Widiana IGR. Kadar HbA1c yang tinggi dan ulkus yang lama sebagai faktor-faktor risiko terjadinya amputasi pada pasien kaki diabetes di rumah sakit umum pusat sanglah. Medicina. 2018;49(1):38–41. Available from: https://doi.org/10.15562/medicina.v49i1.260

Kaneko M, Fujihara K, Harada MY, Osawa T, Yamamoto M, Kitazawa M, et al. Rates and risk factors for amputation in people with diabetes in Japan: a historical cohort study using a nationwide claims database. Journal of Foot and Ankle Research. 2021;14(29). Available from: https://doi.org/10.1186/s13047-021-00474-8

Peng X, Gou D, Zhang L, Wu H, Chen Y, Shao X, et al. Status and influencing factors of lower limb amputation in patients with diabetic foot ulcer. International Wound Journal. 2023;20(6):2075–2081. Available from: https://doi.org/10.1111/iwj.14076




DOI: https://doi.org/10.30596/jih.v6i2.22317

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