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Hubungan Kadar Laktat Darah Dengan Luaran Klinis Pasca Operasi Pasien Cedera Otak Traumatika = Relationship Between Blood Lactate Levels and Post-Operative Clinical Outcome in Traumatic Brain Injury Patients

Amanda Aldilla; Tobing, Hanif Gordang, supervisor; Wismaji Sadewo, supervisor; Nur Agustina, examiner (Fakultas Kedokteran Universitas Indonesia, 2022)

 Abstract

Latar belakang. Laktat awalnya dianggap sebagai produk berbahaya dari metabolisme anaerobik, namun bukti terbaru menunjukkan laktat dapat melindungi neuron dan memperbaiki luaran. Dalam studi ini, kami mencari korelasi antara kadar laktat darah dan luaran pascaoperasi pasien dengan cedera otak traumatika (traumatic brain injury, TBI). Metode. Studi kohort prospektif ini mengambil sampel dari pasien dengan TBI terisolasi yang menjalani operasi di Departemen Bedah Saraf RSUPN dr. Cipto Mangunkusumo dari April 2020 hingga Juni 2021. TBI dikategorikan menjadi ringan (GCS 13-15), sedang (GCS 9-12), dan berat (GCS 3-8). Kadar laktat darah diambil dari vena perifer sebelum dan pada hari ke-3 pascaoperasi. Luaran klinis dievaluasi berdasarkan perubahan (D) GCS pada hari ke-7 pascaoperasi dengan preoperasi, lalu dibagi menjadi 3 kelompok: membaik, tidak berubah, dan memburuk. Hasil. Dari 72 subjek dalam penelitian ini, ditemukan terdapat korelasi yang signifikan (p = 0,019, r = 0,275) antara kadar laktat preoperatif dengan D GCS, dimana semakin tinggi kadar laktat preoperatif maka D GCS akan semakin positif. Berdasarkan analisis dengan kurva receiver operating characteristics (ROC) dan Chi-square, ditemukan bahwa subjek dengan kadar laktat >=2,35 mmol/L memiliki kemungkinan 1,64 kali lebih besar untuk mengalami peningkatan GCS pascaoperasi. Kesimpulan. Laktat dapat dijadikan suatu faktor prognostik luaran baik pascaoperasi pasien TBI.

Background. Lactate was initially thought to be a harmful product of anaerobic metabolism, but recent evidence suggests it can protect neurons and improve outcomes. Therefore, we sought a correlation between blood lactate levels and the postoperative outcome of patients with traumatic brain injury (TBI). Method. This prospective cohort study took samples from patients with isolated TBI who underwent surgery at the Department of Neurosurgery, Cipto Mangunkusumo National Hospital from April 2020 to June 2021. Blood lactate levels were taken from peripheral veins before surgery and on the 3rd postoperative day. The clinical outcome was evaluated based on the change (D) of GCS from before surgery and on the 7th postoperative day, then categorized into 3 groups: improved, unchanged, and worsen. Results. From 72 subjects in this study, significant correlation (p = 0.019, r = 0.275) was found between preoperative lactate levels and D GCS, where the higher preoperative lactate levels, the more positive D GCS would be. Based on the analysis using ROC curve and Chi-square, subjects with lactate levels >=2.35 mmol/L were 1.64 times more likely to experience an increase in postoperative GCS. Conclusion. Lactate can be used as a favorable prognostic factor in TBI patients.

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 Metadata

Collection Type : UI - Tugas Akhir
Call Number : SP-Pdf
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Publishing : Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
Record of Work Spesialis
Cataloguing Source LibUI ind rda
Content Type text
Media Type computer
Carrier Type online resource
Physical Description xv, 47 pages : illustration + appendix
Concise Text
Holding Institution Universitas Indonesia
Location Perpustakaan UI
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SP-Pdf 16-22-12534977 TERSEDIA
Review:
No review available for this collection: 20522922
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