BAB 6 KESIMPULAN DAN SARAN
6.2. Saran
1. Penelitian ini masih merupakan penelitian cross sectional dengan besar sampel yang kecil dan waktu penelitian yang pendek. Oleh karena itu, perlu dilakukan penelitian lebih lanjut dengan sampel yang lebih besar dan waktu penelitian yang lebih panjang dengan melibatkan beberapa rumah sakit di dalam suatu daerah.
2. Meskipun tidak terdapat hubungan yang bermakna secara statistik, namun dijumpai kasus stroke iskemik dengan kelainan jantung sebanyak 63,16% dari total kasus stroke iskemik. Oleh karena itu, perlu dilakukan tindakan pencegahan stroke iskemik pada individu yang memiliki kelainan jantung.
DAFTAR PUSTAKA
Adams, H.P., et al., 2007. Guidelines for Early Management of Adults with Ischemic stroke. Circulation, 115: e478-e534.
Arboix, A., Padilla, I., Massons, J., Garcia-Eroles, L., Comes, E., and Targa, C., 2001. Clinical Study of 222 Patients with Pure Motor Stroke. J Neurol Nourosurg Psychiatry, 71: 239-242.
Davenport, R. & Dennis, M., 2000. Neurological Emergencies: Acute Stroke. J Neurol Neurosurg Psychiatry, 68: 277-288.
Feigin, V.L., Wiebers, D.O., Nikitin, Y.P., O’Fallon, M., and Whisnant, J.P., 1998. Risk Factors for Ischemic Stroke in a Russian Community: a Population-based Case-Control. Stroke, 29: 34-39.
Fischer, U., et. al., 2005. NIHSS Score and Arteriographic Findings in Acute Ischemic Stroke. Stroke, 36: 2121-2125.
Goldberger, A.L., 2005. Electrocardiography. In: Kasper, D.L., Braunwald, E., Fauci, A.S., Hauser, S.L., Longo, D.L., and Jameson, J.L. ed. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill, 1311-1319.
Goldstein, L.B., et al., 2006. Primary Prevention of Ischemic Stroke. Stroke, 37: 1583-1633.
Hasnawati, Sugito, Purwanto, H., dan Brahim, R., 2009. Profil Kesehatan Indonesia 2008. Pusat Data dan Informasi Departemen Kesehatan Republik Indonesia.
Jabaudon, D., Sztajzel, J., Sievert, K., Landis, T., and Sztajzel, R., 2004. Usefulness of Ambulatory 7-Day ECG Monitoring for the Detection of atrial Fibrillation and Flutter After Acute Stroke and Transient Ischemic Attack. Stroke, 35: 1647-1651.
Japardi, I., 2002. Patofisiologi Stroke Infark Akibat Tromboemboli. Bagian Bedah Fakultas Kedokteran Universitas Sumatera Utara. Available from: http://library.usu.ac.id/download/fk/bedah-iskandar%20japardi31.pdf. [Accessed 11 Mar 2010].
Japardi, I., 2002. Patogenesa Stroke Kardioemboli. Bagian Bedah Fakultas Kedokteran Universitas Sumatera Utara. Available from: http://library.usu.ac.id/download/fk/bedah-iskandar%20japardi33.pdf.
[Accessed 11 Mar 2010].
Jones, A.S., 2005. ECG Notes, Interpretation and Management Guide. Philadelphia: F. A. Davis Company.
Kamal, A.K., et al., 2009. The Burden of Stroke and Transient Ischemic Attack in Pakistan: a Community-based Prevalence Study. BMC Neurology, 9: 58.
Lipska, K., et al., 2007. Risk Factors for Acute Ischaemic Stroke in Young Adults in South India. J Neurol Neurosurg Psychiatry, 78: 959-963.
Madiyono, B., Moeslichan, S., Sastroasmoro, S., Budiman, I., dan Purwanto, H. S., 2008. Perkiraan Besar Sampel. Dalam: Sastroasmoro, S. dan Ismael, S. ed. Dasar-dasar Metodologi Penelitian Klinis. Edisi ketiga. Jakarta: Sagung Seto, 302-331.
Mollema, S.A., et al., 2010. Viability Assessment with Global Left Ventricular Longitudinal Strain Predicts Recovery of Left Ventricular Function After Acute Myocardial Infarction. Circ Cardiovasc Imaging, 3: 15-23.
Ritarwan, K., 2002. Pengaruh Suhu Tubuh Terhadap Outcome Penderita Stroke yang Dirawat di RSUP H. Adam Malik Medan. Bagian Ilmu Penyakit Saraf FK USU/RSUP H. Adam Malik Medan.
Sastroasmoro, S. & Ismael, S., 2008. Pemilihan Subjek Penelitian. Dalam: Sastroasmoro, S. dan Ismael, S. ed. Dasar-dasar Metodologi Penelitian Klinis. Edisi ketiga. Jakarta: Sagung Seto, 78-91.
Sjahrir, H., 2003. Stroke Iskemik. Medan: Yandira Agung.
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Yamamoto, H. & Bogousslavsky, J., 1998. Mechanism of Secondary and Further Strokes. J Neurol Neurosurg Psychiatry, 64: 771-776.
LAMPIRAN 1
DAFTAR RIWAYAT HIDUP
Nama : Krisnarta Sembiring Tempat/ Tanggal Lahir : Medan/ 30 Desember 1998 Agama : Kristen Protestan
Riwayat Pendidikan : 1. SD Negeri No. 040448 Kabanjahe 2. SMP Negeri 1 Kabanjahe
3. SMA Negeri 1 Matauli Pandan Riwayat Pelatihan : -
LAMPIRAN 4
LEMBAR CHECK LIST
No. No. MR
Umur Diagnosis Jenis kelamin Kelainan jantung Gambaran EKG Stroke iskemik CT-Scan Skor NIHSS
LAMPIRAN 4
DATA INDUK PENELITIAN
No. No. MR Umur Sex Diagnosis Gambaran EKG
CT scan NIHSS 1 43. 87. 91 56 1 Stroke hemoragik LVH 1 - 2 43. 85.
78 26 1 Spondilitis TB Sinus takikardia 1 -
3
43. 47.
55 14 2 Miastenia gravis SR + iskemik miokardium 1 -
4
42. 02.
21 59 2 HNP SR + normo EKG 1 -
5
03. 61.
79 53 1 Stroke iskemik Sinus bradikardia 2 -
6
43. 76.
48 76 1 Stroke iskemik SR 2 -
7
43. 83.
89 30 2 SOL intrakranial Normo EKG 1 -
8
43. 87.
28 21 2 Trauma kapitis sedang Normo EKG 1 -
9
39. 72.
79 39 1 PPH SR 1 -
10
43. 86.
89 50 1 Trauma kapitis sedang SR + low voltage 1 -
11
36. 89.
99 55 2 SOL medula spinalis SR 1 -
12 43. 94. 50 56 2 SOL intrakranial SR 1 - 13 44. 02. 11 53 1 Stroke iskemik + HT LVH 2 - 14 41. 68.
25 37 2 SOL intrakranial SR + RBBB inkomplit 1 -
15
44. 02.
53 53 2 Stroke iskemik SR + OMI septal 2 -
16
44. 02.
50 47 1 Stroke iskemik Normo EKG 2 -
17
44. 02.
89 66 2 Stroke iskemik SR + OMI septal 2 -
18
44. 03.
55 65 1 Stroke iskemik SR + LVH 2 -
19
44. 03.
59 65 1 Stroke hemoragik SR + LAD + LAE 1 -
20
44. 05.
89 15 1 Brachial palsy Normo EKG 1 -
21
44. 04.
56 56 2 SOL intrakranial + HT SR + iskemik miokardium 1 -
22
44. 08.
87 21 2 SOL intrakranial Sinus takikardia 1 -
23
44. 14.
94 62 2 Stroke iskemik AF + sinus takikardia 2 -
50 25
44. 18.
06 59 2 Vertigo sentral + hipertensi Sinus takikardia 1 -
26
44. 17.
07 85 2 Stroke iskemik Sinus takikardia +OMI anterior inferior 2 -
27
44. 15.
23 74 1 SOL intrakranial Normo EKG 1 -
28
44. 11.
64 43 2 Meningitis OMI anterior inferior 1 -
29
44. 08.
74 50 1 Stroke hemoragik SR + iskemik inferior 1 -
30
44. 11.
84 50 1 Stroke iskemik SR + iskemik lateral + LVH 2 -
31
44. 09.
18 32 1 Stroke iskemik Normo EKG 2 -
32
44. 24.
36 54 1 SOL intrakranial Normo EKG 1 -
33
44. 23.
75 40 1 Fraktur kompresi SR + OMI anterior 1 -
34
44. 23.
47 60 1
SOL medula spinalis +
myelitis Normo EKG 1 -
35
39. 99.
78 54 1 Stroke iskemik + HT Normo EKG 2 -
36
44. 20.
35 20 2 Ensefalitis Normo EKG 1 -
37
43. 12.
10 48 1 Stroke iskemik Normo EKG 2 -
38
44. 54.
54 60 1 Stroke iskemik SR + iskemik miokard 2 -
39
44. 28.
58 49 1 Stroke iskemik Normo EKG 2 -
40
44. 26.
71 50 2 Stroke iskemik Normo EKG 2 -
41
28. 04.
84 50 2 Metastasis tumor otak Low voltage + infark anterolateral 1 -
42
44. 19.
16 65 2 Stroke iskemik SR + RBBB inkomplit 2 -
43
44. 31.
70 52 2 Stroke hemoragik Ectopic atrial rhythm 1 -
44
44. 31.
28 45 2 Spondilitis TB Sinus takikardia + LVH 1 -
45
44. 32.
83 70 1 Stroke iskemik
SR + iskemik miokard inferior + LVH +
CAD 2 -
46
44. 06.
25 44 1 Stroke iskemik Iskemik lateral 2 -
Keterangan:
Sex CT scan
1 = Laki-laki 1 = Bukan stroke iskemik
LAMPIRAN 6
OUTPUT SPSS UNTUK UJI CHI SQUARE
Case Processing Summary
Cases
Valid Missing Total
N Percent N Percent N Percent
Gambaran EKG * Hasil CT-Scan
46 100.0% 0 .0% 46 100.0%
Gambaran EKG * Hasil CT-Scan Crosstabulation
Hasil CT-Scan
Total Stroke iskemik
Bukan stroke iskemik
Gambaran EKG Normal Count 7 12 19
% within Hasil CT-Scan 36.8% 44.4% 41.3%
Tidak normal Count 12 15 27
% within Hasil CT-Scan 63.2% 55.6% 58.7%
Total Count 19 27 46
Chi-Square Tests Value df Asymp. Sig. (2-sided) Exact Sig. (2-sided) Exact Sig. (1-sided) Pearson Chi-Square .266a 1 .606 Continuity Correctionb .045 1 .832 Likelihood Ratio .267 1 .605
Fisher's Exact Test .763 .418
Linear-by-Linear Association
.260 1 .610
N of Valid Cases 46
a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 7.85.