Abstrak
Hubungan Derajat Skor CURB-65 Saat Awal Masuk Pada Pasien Pneumonia Komunitas Terhadap Nilai Antithrombin III (AT-III)
Sari Andriyani, E.N. Keliat, Alwinsyah Abidin, Divisi Pulmonologi dan Alergi Immunologi
Departemen Ilmu Penyakit Dalam
Fakultas Kedokteran Universitas Sumatera Utara RSUP.H.Adam Malik Medan
Latar Belakang
Pada penderita pneumonia komunitas, melakukan penilaian derajat keparahan pada awal pasien masuk sangat penting sebab akan menentukan beratnya penyakit dan rencana tatalaksana selanjutnya. Antithrombin III sebagai biomarker koagulasi yang berguna untuk menilai tingkat keparahan PK pada saat awal masuk Antithrombin III dapat berperan dalam diagnosis, memutuskan pemberian antibiotik dan prognosis penderita PK.
Tujuan :
Untuk mengetahui hubungan skor CURB-65 terhadap nilai Antithrombin III (AT-III) pada saat awal pasien pneumonia komunitas datang ke rumah sakit.
Bahan dan Cara :
Penelitian observasional analitik dengan metode pengukuran cross sectional. Subjek dengan pneumonia komunitas yang masuk dari instalasi gawat darurat,maupun pasien rawat jalan setelah memenuhi kriteria dilakukan penilaian skor CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, Age>65 years), laboratorium darah, kultur sputum dan darah. Selanjutnya skor CURB-65 dihubungkan dengan AT-III dan parameter lainnya.
Hasil :
Sebanyak 55 subjek penelitian dimana subjek yang tergolong dalam skor CURB-65 berat (3-5) sebanyak 23 orang (41,8%), skor sedang ( 2 ) sebanyak 17 orang (30,9% ) dan skor ringan (0-1) sebanyak 15orang (27,3%). Setelah dilakukan uji korelasiSpearman diperoleh hubungan signifikan antara derajat skor CURB-65 dengan nilai Antithrombin III (p= 0,0001).
Kesimpulan :
Antithrombin IIImerupakan biomarker koagulasi yang memiliki hubungan dengan derajat keparahan PK yang dinilai dengan skor CURB-65 sehingga Anti thrombin III dapat digunakan untuk menentukan prognosis pasien PK sejak awal masuk rumah sakit.
Kata Kunci :Pneumonia Komunitas, Skor CURB-65, Antithrombin III, Prognosis.
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Abstract
The Correlation Between Prognosis Scoring CURB-65 and Antithrombin III
in Community Acquired Pneumonia at Early Admission in Hospital Sari Andriyani, E.N. Keliat, Alwinsyah Abidin,
Division of Pulmonology and Allergy-Immunology Department of Internal Medicine
Medical Faculty of UniversitySumatera Utara H. Adam Malik General Hospital Medan
Background
The assessment of level severity in patient with community acquired pneumonia (CAP) is very important to determine the next management of disease. Antithrombin III is known as one of biomarker coagulation may be helpful in predicting the severity of CAP at the early admission in hospital.The application of Antithrombin III is known to be used in diagnosis, to help clinician to decide antibiotic treatment and to make prognosis.
Objective :
To determine the correlation between CURB-65 score and Antithrombin III in CAP patients at the early admission in hospital.
Materials and Methods :
An analytical observational study was conducted using the cross-sectional measurement method. We had examined CAP subject with CURB-65 (Confusion, Urea, Respiratory rate, Blood pressure, Age >65 years), Antithrombin III, other laboratory assessment and sputum and blood culture at the early admission at emergency room (ER) and outpatient. We had correlate the CURB-65 score with Antithrombin III to determined prognostic utility of Antithrombin III.
Result:
Total of CAP subject was 55, consist of 23 subjects (41.8%), with severe CURB-65 scores (3-5), moderate scores (2) as many as 17 subjects (30.9%) and mild scores (0-1) as many as 15 subjects (27.3%). We had found a significant correlation between CURB-65 with Antithrombin III using Spearman correlation test (p= 0,0001) .
Conclusion :
Antithrombin III is a biomarker of coagulation that has correlation with clinical scoring system CURB-65. Antithrombin III can be use to determine the prognosis in CAP at early admission in hospital.
Key Word : Community Acquired Pneumonia, CURB-65 score, Antithrombin III, Prognosis.
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