Hubungan Nilai Mean Platelet Voulme (Mpv) Dengan Derajat Sepsis

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LAMPIRAN 2

LEMBARAN PENJELASAN

Salam Sejahtera.

Terima kasih atas kesediaan Bapak/Ibu meluangkan waktu untuk

membaca dan mengisi surat persetujuan ini, sebelumnya, perkenankan saya

memperkenalkan diri. Nama saya dr. Andi Raga Ginting, peserta Pendidikan

Pasca Sarjana Ilmu Penyakit Dalam / Magister Klinik FK USU Medan akan

melakukan penelitian yang berjudul ”Perbedaan nilai Mean Platelet Volume

(MPV) pada sepsis dan sepsis berat”.

Pada Bapak/Ibu yang bersedia mengikuti penelitian ini nantinya akan

diminta mengisi surat persetujuan ikut dalam penelitian, mengikuti wawancara

untuk mencari adanya hal-hal yang dapat mengganggu penelitian, dilakukan

pengukuran tanda-tanda vital, pemeriksaan laboratorium berupa pemeriksaan

darah sebanyak 15 cc (1 sendok makan)yang akan diambil dari lengan oleh

ahlinya untuk menilai parameter darah rutin,Mean Platelet Volume (MPV) yaitu

ukuran rata-rata dari trombosit/platelet , prokalsintonin dan kultur darah (biakan

darah untuk identifikasi kuman penyebab infeksi) yang diperiksakan di

laboratorium patologi klinis RS H. Adam Malik Medan. Namun kemungkinan

komplikasi yang timbul saat pengambilan darah adalah rasa nyeri pada daerah

tempat pemgambilan darah dan juga infeksi pada kulit tempat pengambilan darah

yang sangat jarang terjadi.

Manfaat penelitian ini adalah membantu dan memberi informasi awal

tentang sepsis dan derajat keparahnnya, sehingga diharapkan nantinya dapat

membantu diagnosa dan manajemen sepsis lebih cepat, sederhana, murah dan

tidak membutuhkan waktu yang lama.Setelah hasil akhir diperoleh, nantinya akan

terlihat apakah terdapat hubungan antara perbandingan nilai Mean Platelet

Volume (MPV) yang didapat dari pemeriksaan darah rutin dengan derajat

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Segala biaya pemeriksaan laboratorium menjadi tanggung jawab peneliti.

Bila masih terdapat pertanyaan atau keluhan sewaktu penelitian ini berjalan, maka

Bapak/Ibu dapat menghubungi saya pada:

Nama

: dr. Andi Raga Ginting

Alamat

: Jl. Sei Selayang No.23 Medan

Telepon

: 081263338605

Peneliti,

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LAMPIRAN 3

SURAT PERSETUJUAN SETELAH PENJELASAN

(INFORMED CONSENT)

Saya yang bertandatangan dibawah ini :

Nama

:

Alamat

:

Umur

:

tahun

Jenis kelamin : Laki-laki/Perempuan

*

No. telp/HP

:

Setelahmendapat penjelasan dari peneliti tentang kebaikan dan keburukan

prosedur penelitian ini, menyatakan bersedia

Demikianlah surat persetujuan bersedia ikut dalam penelitian ini saya buat, untuk

dapat digunakan seperlunya.

ikut serta dalam penelitian tentang

”Perbedaan nilai Mean Platelet Volume (MPV) pada sepsis dan sepsis

berat”.Apabila sewaktu-waktu saya mengundurkan diri dari penelitian ini, kepada

saya tidak dituntut apapun.

Medan, 20__

Saksi,Yang memberi pernyataan,

(...) (...)

*

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LAMPIRAN 4

LEMBAR OBSERVASI PASIEN

NO: ____ /____ /20__

Diagnosis akhir : Non-Sepsis Sepsis

Sepsis Berat :Sepsis + minimal 1 tanda dari hipoperfusi atau disfungasi organ

Areas of mottled skin

Capillary refilling time ≥ 3detik

Urin output < 0.5mL/kg dalam 1 jam atau renal replacementtherapy Laktat > 2mmol/L

Perubahan kesadaran tiba-tiba atauelectroencephalogram tidak normal

Jumlah trombosit < 100000/mL atau disseminated intravascular

coagulation

Acute lung injury - acute respiratory distress syndrome Cardiac disfunction

Menggunakan ventilator : ya tidak

Gagal ginjal akut : ya tidak

GCS : E ___ M___ V___

Pemeriksaan fisik awal masuk :

Suhu tubuh : , °C

Sistolik : mmHg

Diastolik : mmHg

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Laju nafas : / menit

Pemeriksaan laboratorium

Hb, Leukosit, Trombosit, MPV, Urinalisa, Ureum, Kreatinin, Laktat, AGDA, Kultur Darah

Foto Thorax, USG Ginjal

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LAMPIRAN 5

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LAMPIRAN 6

OUTPUT ANALISIS

**Jenis Kelamin * kelompok**

Jenis Kelamin * Kelompok Crosstabulation

Kelompok

Total Sepsis Non-Sepsis

Jenis Kelamin Laki-laki Count 24 20 44

Continuity Correctionb ,365 1 ,546

Likelihood Ratio ,650 1 ,420

Fisher's Exact Test ,546 ,273

Linear-by-Linear Association ,643 1 ,423

N of Valid Cases 100

a. 0 cells (0,0%) have expected count less than 5. The minimum expected count is 22,00.

b. Computed only for a 2x2 table

Descriptives

Kelompok Statistic Std. Error

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95% Confidence Interval for

Variance 308.630

Std. Deviation 17.568

Minimum 18

Maximum 96

Range 78

Interquartile Range 28

Skewness .058 .337

Kurtosis -.308 .662

Non-Sepsis Mean 53.88 1.949

Mean

Lower Bound 49.96

Upper Bound 57.80

5% Trimmed Mean 53.92

Median 54.50

Variance 189.944

Minimum 25

Maximum 82

Range 57

Skewness -.160 .337

Kurtosis -.407 .662

TD Sistolik Sepsis Mean 111.06 3.240

Mean

Lower Bound 104.55

Upper Bound 117.57

Median 110.00

Variance 524.915

Minimum 60

Maximum 180

Range 120

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Kurtosis 1.411 .662

Mean

Lower Bound 120.51

Upper Bound 127.09

Median 120.00

Variance 134.245

Minimum 100

Maximum 160

Range 60

Skewness .755 .337

Kurtosis 1.299 .662

TD Diastolik Sepsis Mean 64.64 2.251

Mean

Lower Bound 60.12

Upper Bound 69.16

Median 60.00

Variance 253.337

Minimum 30

Maximum 100

Range 70

Skewness .353 .337

Kurtosis .185 .662

Mean

Lower Bound 70.86

Upper Bound 77.94

Median 80.00

Variance 154.735

Minimum 50

Maximum 110

Range 60

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Kurtosis .020 .662

HR Sepsis Mean 100.40 1.033

Mean

Lower Bound 98.33

Upper Bound 102.47

Median 99.00

Variance 53.306

Minimum 85

Maximum 124

Range 39

Skewness .637 .337

Kurtosis 1.267 .662

Mean

Lower Bound 78.79

Upper Bound 84.17

Median 84.00

Variance 89.765

Minimum 62

Maximum 98

Range 36

Skewness -.568 .337

Kurtosis -.660 .662

RR Sepsis Mean 28.52 .480

Mean

Lower Bound 27.56

Upper Bound 29.48

Median 30.00

Variance 11.520

Minimum 20

Maximum 34

Range 14

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Kurtosis .692 .662

Non-Sepsis Mean 21.72 .656

Mean

Lower Bound 20.40

Upper Bound 23.04

Median 21.50

Variance 21.512

Minimum 14

Maximum 36

Range 22

Skewness .690 .337

Kurtosis .504 .662

Temp Sepsis Mean 38.602 .0945

Mean

Lower Bound 38.412

Upper Bound 38.792

Median 39.000

Variance .447

Std. Deviation .6684

Minimum 37.0

Maximum 40.0

Range 3.0

Interquartile Range .6

Skewness -1.082 .337

Kurtosis .872 .662

Mean

Lower Bound 36.805

Upper Bound 37.283

Median 37.000

Variance .706

Minimum 36.0

Maximum 39.0

Range 3.0

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Skewness .466 .337

Kurtosis -.554 .662

Tests of Normality

Kelompok

Kolmogorov-Smirnova Shapiro-Wilk

Statistic df Sig. Statistic df Sig.

*. This is a lower bound of the true significance.

a. Lilliefors Significance Correction

T-Test

Group Statistics

Kelompok N Mean Std. Deviation Std. Error Mean

Umur Sepsis 50 56.32 17.568 2.484

Non-Sepsis 50 53.88 13.782 1.949

Independent Samples Test

Levene's Test

for Equality of

Variances t-test for Equality of Means

F Sig. t df

Interval of the

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Equal

variances not

assumed

-773 92.744 .442 2.440 3.158 -3.831 8.711

Asal Infeksi * Kelompok Crosstabulation

Kelompok

Total Sepsis Non-Sepsis

Asal Infeksi Pulmo Count 37 29 66

Linear-by-Linear Association 2.812 1 .094

N of Valid Cases 100

a. 4 cells (50.0%) have expected count less than 5. The minimum

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Case Processing Summary

Kelompok Statistic Std. Error

MPV Sepsis Mean 10.9680 .08850

Mean

Lower Bound 10.7902

Upper Bound 11.1458

Median 10.8500

Variance .392

Minimum 10.00

Maximum 12.40

Range 2.40

Skewness .703 .337

Kurtosis -.278 .662

Mean

Lower Bound 8.9585

Upper Bound 9.3855

Median 9.1000

Variance .564

Minimum 7.40

Maximum 10.80

Range 3.40

Skewness -.157 .337

Kurtosis -.281 .662

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Kelompok

MPV Sepsis .133 50 .028 .935 50 .009

Non-Sepsis .099 50 .200* .986 50 .812

NPar Tests

Mann-Whitney U 53.000

Wilcoxon W 1328.000

Z -8.261

Asymp. Sig. (2-tailed) .000

a. Grouping Variable: Kelompok

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Sepsis Berat 33 100.0% 0 0.0% 33 100.0%

Temp Sepsis 17 100.0% 0 0.0% 17 100.0%

Sepsis Berat 33 100.0% 0 0.0% 33 100.0%

Descriptives

Keparahan sepsis Statistic Std. Error

Umur Sepsis Mean 51.71 4.514

Mean

Lower Bound 42.14

Upper Bound 61.28

Median 49.00

Variance 346.471

Minimum 18

Maximum 96

Range 78

Skewness .761 .550

Kurtosis 1.091 1.063

Sepsis Berat Mean 58.70 2.924

Mean

Lower Bound 52.74

Upper Bound 64.65

Median 59.00

Variance 282.218

Minimum 23

Maximum 92

Range 69

Skewness -.288 .409

Kurtosis -.322 .798

TD Sistolik Sepsis Mean 121.76 3.120

Mean

Lower Bound 115.15

Upper Bound 128.38

Median 120.00

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Minimum 110

Maximum 160

Range 50

Skewness 1.627 .550

Mean

Lower Bound 96.65

Upper Bound 114.44

Median 110.00

Variance 628.818

Minimum 60

Maximum 180

Range 120

Skewness .380 .409

Kurtosis 1.355 .798

TD Diastolik Sepsis Mean 70.53 2.906

Mean

Lower Bound 64.37

Upper Bound 76.69

Median 69.00

Variance 143.515

Minimum 60

Maximum 100

Range 40

Skewness .880 .550

Kurtosis .326 1.063

Mean

Lower Bound 55.59

Upper Bound 67.63

Median 60.00

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Minimum 30

Maximum 100

Range 70

Skewness .588 .409

Kurtosis .341 .798

HR Sepsis Mean 97.94 1.415

Mean

Lower Bound 94.94

Upper Bound 100.94

Median 98.00

Variance 34.059

Minimum 88

Maximum 110

Range 22

Skewness .530 .550

Mean

Lower Bound 98.93

Upper Bound 104.41

Median 100.00

Variance 59.729

Minimum 85

Maximum 124

Range 39

Skewness .513 .409

Kurtosis 1.228 .798

RR Sepsis Mean 27.29 .938

Mean

Lower Bound 25.30

Upper Bound 29.28

Median 28.00

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Minimum 20

Maximum 32

Range 12

Skewness -.722 .550

Kurtosis -.636 1.063

Sepsis Berat Mean 29.15 .521

Mean

Lower Bound 28.09

Upper Bound 30.21

Median 30.00

Variance 8.945

Minimum 20

Maximum 34

Range 14

Kurtosis 2.218 .798

Temp Sepsis Mean 38.441 .1539

Mean

Lower Bound 38.115

Upper Bound 38.767

Median 38.500

Variance .403

Minimum 37.0

Maximum 39.0

Range 2.0

Interquartile Range 1.0

Kurtosis .075 1.063

Mean

Lower Bound 38.444

Upper Bound 38.926

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Variance .462

Minimum 37.0

Maximum 40.0

Range 3.0

Kurtosis 1.747 .798

Keparahan sepsis

Keparahan sepsis N Mean Std. Deviation Std. Error Mean

Umur Sepsis 17 51.71 18.614 4.514

Sepsis Berat 33 58.70 16.799 2.924

Levene's Test

for Equality of

Variances t-test for Equality of Means

F Sig. t df

Interval of the

Difference

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Umur Equal variances

Mann-Whitney U 142.500 183.500 180.000 206.500 208.500

Wilcoxon W 703.500 744.500 333.000 359.500 361.500

Z -2.872 -2.084 -2.108 -1.563 -1.613

Asymp. Sig. (2-tailed) .004 .037 .035 .118 .107

a. Grouping Variable: Keparahan sepsis

Crosstab

Keparahan sepsis

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Jenis Kelamin Laki-laki Count 10 14 24

% within Keparahan sepsis 100.0% 100.0% 100.0%

Chi-Square Tests

Continuity Correctionb .641 1 .423

Likelihood Ratio 1.213 1 .271

Fisher's Exact Test .373 .212

N of Valid Cases 50

a. 0 cells (0.0%) have expected count less than 5. The minimum expected count is 8.16.

**Jenis Kelamin * Keparahan sepsis**

Crosstab

Keparahan sepsis

Total Sepsis Sepsis Berat

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Total Count 17 33 50

Expected Count 17.0 33.0 50.0

% within Jenis Kelamin 34.0% 66.0% 100.0%

% within Keparahan sepsis 100.0% 100.0% 100.0%

Chi-Square Tests

Continuity Correctionb .641 1 .423

Likelihood Ratio 1.213 1 .271

Fisher's Exact Test .373 .212

N of Valid Cases 50

a. 0 cells (0.0%) have expected count less than 5. The minimum expected count is 8.16.

Keparahan sepsis

Keparahan sepsis Statistic Std. Error

MPV Sepsis Mean 10.5235 .06504

Mean

Lower Bound 10.3857

Upper Bound 10.6614

Median 10.5000

Variance .072

Minimum 10.00

Maximum 11.00

Range 1.00

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Skewness -.439 .550

Kurtosis .038 1.063

Mean

Lower Bound 10.9714

Upper Bound 11.4225

Median 11.1000

Variance .405

Minimum 10.20

Maximum 12.40

Range 2.20

Skewness .253 .409

Kurtosis -.778 .798

Keparahan sepsis

MPV Sepsis .230 17 .017 .925 17 .182

Sepsis Berat .106 33 .200* .959 33 .239

Levene's Test

for Equality of

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F Sig. t df

Interval of the

Difference

Statistic Std. Error

MPV Mean 10.0700 .11347

Mean

Lower Bound 9.8448

Upper Bound 10.2952

Median 10.2000

Variance 1.288

Minimum 7.40

Maximum 12.40

Range 5.00

Skewness -.126 .241

Kurtosis -.559 .478

Procalcitonin Mean 5.5396 .83531

Mean

Lower Bound 3.8822

Upper Bound 7.1970

Median 1.3150

Variance 69.775

Minimum .04

Maximum 42.39

Range 42.35

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Skewness 2.318 .241

Kurtosis 6.074 .478

MPV .088 100 .056 .985 100 .302

Procalcitonin .255 100 .000 .692 100 .000

Nonparametric Correlations

Correlations

MPV Procalcitonin

Spearman's rho MPV Correlation Coefficient 1.000 .702**

Sig. (2-tailed) . .000

N 100 100

Procalcitonin Correlation Coefficient .702** 1.000

Sig. (2-tailed) .000 .

N 100 100

**. Correlation is significant at the 0.01 level (2-tailed).

kelompok2 Valid N (listwise)

Positivea 50

Negative 50

Larger values of the test result

variable(s) indicate stronger

evidence for a positive actual

state.

a. The positive actual state is

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Area Under the Curve

Test Result Variable(s): MPV_fl

Area Std. Errora Asymptotic Sig.b

Asymptotic 95% Confidence

Interval

Lower Bound Upper Bound

,979 ,012 ,000 ,955 1,000

The test result variable(s): MPV_fl has at least one tie between the positive actual

state group and the negative actual state group. Statistics may be biased.

a. Under the nonparametric assumption

b. Null hypothesis: true area = 0.5

Coordinates of the Curve

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13,400 ,000 ,000

The test result variable(s): MPV_fl has at least one tie between the

positive actual state group and the negative actual state group.

a. The smallest cutoff value is the minimum observed test value minus

1, and the largest cutoff value is the maximum observed test value

plus 1. All the other cutoff values are the averages of two consecutive

ordered observed test values.

MPVkat * kelompok Crosstabulation

kelompok

Total sepsis non sepsis

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LAMPIRAN 7

DAFTAR RIWAYAT HIDUP

I. DATA PRIBADI

Istri

: Faradila Yulistari Stiepu, S.H M.H

Anak

: 1. Naafa Maisyva Ginting

2. Ranaya Zhafira Ginting

Alamat pekerjaan

: Fakultas Kedokteran Universitas Sumatera Utara

Jl. dr. Mansyur no. 5 Medan

Departemen Ilmu Penyakit Dalam

RSUP. H. Adam Malik Medan

Jl. Bunga Lau no.17 Medan

Alamat rumah

: Jl. Sei Selayang No. 23. Medan

Telepon selular

: 081263338605

II. PENDIDIKAN

1. SD N 106812 (1992-1998) di Percut Sei Tuan

2. SMP N 1 Percut Sei Tuan (1998-2001) di Percut Sei Tuan

3. SMANegeri 2 Medan (2001-2004) di Medan

4. Fakultas Kedokteran Universitas Sumatera Utara (2004-2010) di

Medan-Sumatera Utara.

5. PPDS IlmuPenyakit Dalam Fakultas Kedokteran Universitas Sumatera

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III. RIWAYAT PEKERJAAN

Dokter Perusahaan PT Asam Jawa (2010 – 2011)

IV. KEANGGOTAAN PROFESI

1.Ikatan Dokter Indonesia (IDI)

2.Perhimpunan Ahli Penyakit Dalam Indonesia (PAPDI)

V. KURSUS PENATARAN

1. Kursus USG. PUSKI, Medan 2011.

2. Kursus Basic Pulmonary Life Support (BPLS), PDPI, Medan 2014.

VI. KARYA ILMIAH

1. Andi Raga Ginting, Abdurrahim Rasyid Lubis. Hubungan Penyakit

Ginjal Kronis dengan kondisi higiene oral pada pasien hemodialisis di

RS. H. Adam Malik Medan. PERNEFRI. Bali, Oktober 2012.

2. Andi Raga Ginting, Savita Handayani, Dairion Gatot. Adenocarcinoma

Recti in HIV patient. PERHOMPEDIN, Mei 2014.

VII. PARTISIPASI DALAM KEGIATAN ILMIAH

1. Peserta SimposiumPerhimpunan Nefrologi Indonesia (PERNEFRI)

Bali, Oktober 2012.

2. Peserta Simposium Diabetic Neuropathy PERKENI. Medan, 08

September 2012.

3. Peserta Workshop Terapi Insulin, Update on Diagnosis and

Management of Common Clinical Problems. Dies Natalis 60 tahun FK

USU. Medan, 11 September 2012.

4. Peserta Siomposium The New Era in Antithrombotic Therapy.

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