[ABSTRAK
Tujuan: Mendapatkan alat (Mikrokapiler Digital/MD) untuk mengukur viskositasdarah dan plasma yang mempunyai presisi dan akurasi yang baik. Mengetahuiperan viskositas darah dan plasma yang diukur dengan MD, faktor risiko dandeterminan terhadap prognosis stroke iskemik akut berdasarkan National Instituteof Health Stroke Scale (NIHSS), Modified Rankin Score (mRS), Interleukin 6 (IL-6),dan neuron-specific enolase (NSE). Penelitian tahap pertama meliputi uji presisidan akurasi, sedangkan tahap kedua adalah uji prognosis.Subjek penelitian: Subjek untuk uji presisi adalah 40 dewasa sehat yangmelakukan Medical Check Up (MCU). Subjek untuk uji akurasi dan prognosisadalah 135 pasien stroke iskemik akut onset ≤ 3 hari, usia 35 – 74 tahun.Pengukuran dan intervensi: Presisi dinilai dengan coefficient of variation (CV),interrater variability Cronbach Alpha dan coefficient of reliability Bland Altman.Akurasi dinilai dengan uji diagnostik. Uji prognosis meliputi analisis bivariatdilanjutkan dengan analisis multivariat cox proportional hazards regression.Hasil: Dari penelitian tahap pertama, didapatkan CV sebesar 0,04, nilai interratervariability Cronbach Alpha dan mean difference Bland Altman adalah baik.Sensitivitas dan spesifisitas MD untuk viskositas darah adalah 88,9 % dan 88,9 %,sedangkan untuk viskositas plasma adalah 100 % dan 84 %. Rumus prediksi untukkonversi viskositas darah MD ke satuan poise adalah y = 0,846x + 0,614, danuntuk viskositas plasma adalah y = 1,072x + (-0,160). Pada uji tahap kedua,didapatkan faktor determinan antara lain: fibrinogen merupakan faktor determinanperubahan viskositas darah dan plasma; viskositas darah merupakan faktordeterminan perburukan kondisi klinis (National Institute of Health Stroke Scale/NIHSS dan modified Rankin Scale/mRS); viskositas darah dan diabetes melitus(DM) merupakan faktor determinan prognosis stroke iskemik akut berdasarkaninterleukin 6 (IL-6); dan HDL merupakan faktor determinan prognosis strokeiskemik akut berdasarkan neuron specific enolase (NSE).Simpulan: MD memiliki presisi dan akurasi yang baik. Viskositas darah merupakanfaktor determinan perburukan kondisi klinis baik akut maupun pasca perawatan.
ABSTRAK
Objectives: To design a simple and portable instrument (Digital Microcapillary) formeasuring blood and plasma viscosity values with high precision and accuracy. Toassess the roles of these values, the risk and determining factors in predicting theoutcome of acute ischemic stroke assessed using National Institute of HealthStroke Scale (NIHSS), modified Rankin Scale (mRS), interleukin 6 (IL-6), andneuron specific enolase (NSE). The first stage of this study included precision andaccuracy tests, while the second stade was the prognostic test.Research subjects: 40 healthy adults admitted for Medical Check Up (MCU) wererecruited for the precision test while the subjects for accuracy and prognostic testswere 135 acute ischemic stroke patients, either inpatients or outpatients, aged 35 –74 years old, with up to 3 days stroke onset.Measurement and intervention: The precision was assessed by calculatingcoefficient of variation (CV), Cronbach Alpha interrater variability, and BlandAltman coefficient of reliability, while the accuracy was assessed using diagnostictest. The prognostic test included bi- and multivariate analyses using Coxproportional hazards regression.Results: The results of the first stage study were that the CV was 0.04; CronbachAlpha interrater variability and Bland Altman mean difference values wereexcellent. The prediction formula used to convert blood viscosity value measuredwith digital microcapillary to poise unit was y = 0.846x + 0.614, and the formulafor plasma viscosity was y = 1.072x + (-0.160). The sensitivity and specificity ofDigital Microcapillary for blood viscosity measurement were 88.9 % and 88.9 %,respectively and for plasma viscosity measurement were 100 % and 84 %,respectively. The second stage of the study showed that the variables proven to be thedeterminants were: fibrinogen as the determinant of blood and plasma viscosity,blood viscosity as the determinant of clinical outcome (NIHSS and mRS), bloodviscosity and diabetes mellitus as the determinants of acute ischemic stroke outcomeindicated by blood IL-6 level, and HDL as the determinant of acute ischemic strokeoutcome indicated by NSE level.Conclusions: Digital Microcapillary has high precision and accuracy. Bloodviscosity is a determining factor in the ischemic stroke outcome, both acute and onemonth after hospital discharge., Objectives: To design a simple and portable instrument (Digital Microcapillary) formeasuring blood and plasma viscosity values with high precision and accuracy. Toassess the roles of these values, the risk and determining factors in predicting theoutcome of acute ischemic stroke assessed using National Institute of HealthStroke Scale (NIHSS), modified Rankin Scale (mRS), interleukin 6 (IL-6), andneuron specific enolase (NSE). The first stage of this study included precision andaccuracy tests, while the second stade was the prognostic test.Research subjects: 40 healthy adults admitted for Medical Check Up (MCU) wererecruited for the precision test while the subjects for accuracy and prognostic testswere 135 acute ischemic stroke patients, either inpatients or outpatients, aged 35 –74 years old, with up to 3 days stroke onset.Measurement and intervention: The precision was assessed by calculatingcoefficient of variation (CV), Cronbach Alpha interrater variability, and BlandAltman coefficient of reliability, while the accuracy was assessed using diagnostictest. The prognostic test included bi- and multivariate analyses using Coxproportional hazards regression.Results: The results of the first stage study were that the CV was 0.04; CronbachAlpha interrater variability and Bland Altman mean difference values wereexcellent. The prediction formula used to convert blood viscosity value measuredwith digital microcapillary to poise unit was y = 0.846x + 0.614, and the formulafor plasma viscosity was y = 1.072x + (-0.160). The sensitivity and specificity ofDigital Microcapillary for blood viscosity measurement were 88.9 % and 88.9 %,respectively and for plasma viscosity measurement were 100 % and 84 %,respectively. The second stage of the study showed that the variables proven to be thedeterminants were: fibrinogen as the determinant of blood and plasma viscosity,blood viscosity as the determinant of clinical outcome (NIHSS and mRS), bloodviscosity and diabetes mellitus as the determinants of acute ischemic stroke outcomeindicated by blood IL-6 level, and HDL as the determinant of acute ischemic strokeoutcome indicated by NSE level.Conclusions: Digital Microcapillary has high precision and accuracy. Bloodviscosity is a determining factor in the ischemic stroke outcome, both acute and onemonth after hospital discharge.] |
D-Pdf Al-Rasyid.pdf :: Unduh