Body mass index and incidence of hematoma

106 PROCEEDING BOOK The 2 nd International Conference on Health Science 2015

2. Multivariate Analysis

Based on the results of the bivariate analysis with chi-square of five variables administration of medication types, sheath size, systolic blood pressure values, frequency puncture and TR Band obtained pvalue 0.05 means that fi ve variables can continue to do the analysis for the logistic regression model determine the most dominant factor to the incidence of hematoma of these fi ve factors. Based on the results of the results of multivariate logistic regression analysis of the fi ve variables signifi cantly infl uence the incidence of hematoma, these fi ve variables are the number of drug types, sheath size, blood pressure, puncture frequency, size TR Brand. Logistic regression analysis results of fi ve variables that affect the occurrence of hematoma in patients undergoing transradial Cardiac Catheterization action at Hospital Dr. Sardjito is the amount of anticoagulant drug administration. This means that after fi ve factors that infl uence the incidence of hematoma tested simultaneously then showed that patients given anticoagulant drugs two or more kinds 19 .115 times have infl uence on the incidence of hematoma in patients undergoing transradial cardiac catheterization in Hospital Dr. Sardjito compared to other variables. While the smallest effect on multivariate phase is the frequency puncture. During cardiac catheterization action has been correlated unfractionated heparin, the dose and increased partial thromboplastin time to improve vaskular 17 complications. Anticoagulation drugs used during cardiac catheterization action is unfractionated heparin UFH 21 . Heparin is aprimary anticoagulant where the effect is to disable thrombin and inhibits factor X via antithrombin, by inactivating thrombin, the heparin not only prevents the formation of fi brin but also inhibits the activation of thrombin-induced platelet and factors V and VIII, UFH is thrombin inhibitor indirectly, and requires the presence of cofactor antithrombin to be effective. Heparin is a specifi c action and nonlinear, and each patient responds differently to heparin doses 13 . Active Heparin sometimes free to do more work on antithrombin. Heparin worksare in the same lane at work clotting factors XIIa, Xa, and IXa serine protease others. Binding of heparin on coagulation factors and antithrombin both very important in enhancing antithrombin. Work heparin on factor Xa are also mediated by increased affi nity of antithrombin for clotting factors but did not bind factor Xa heparin. Factor Xa inhibiting improvement compared with lower levels of heparin that has been measured to inhibit thrombin. Heparin reduces platelet agresasi secondary to the reduction in thrombin a potent cause of platelet aggregation. An increase in lipases cause increased plasma free fatty acids. UFH anticoagulation and antiplatelet group aims to improve Activated Cloting Time ACT and Activated Thromboplastin Time APTT. Improved ACT and APTT is required when the patient underwent cardiac catheterization to prevent blood clotting and thrombus occurrence, on the other hand with an increase in ACT may increase the risk of bleeding in patients post cardiac catheterization 11 . Patients who underwent cardiac catheterization have already got the drug Aspilet or clopidogrel or class of antiplatelet, this class of drugs prevents adhesion and aggregation of platelets by inhibiting a receptor on the membrane of platelets, preventing the interaction of platelets or the interaction of platelets premises chemicals blood clotting another 14 . The impact of these drugs is going to increase bleeding and increase the risk of hematoma. “Optimizing The Quality of Life Children Under SDGs” Sustainable Development Goals 107 Some patients with acute coronary syndrome before action catheterization get thrombolytic agent drug where the drug works by activating plasminogen to plamin which then break up the threads of fi brin in the blood clot to dissolve blood clots antitrombolitik 14 . The impact of this drug will also increase bleeding and improve the risk of hematoma after transradial cardiac catheterization. Changes in the blood clotting in case of patients with cardiac catheterization action will increase the occurrence of hematoma 11 . The amount of medication that could affect blood coagulation will affect the incidence of hematoma. In this study showed that the most dominant factor in the occurrence of hematoma on the action transradial cardiac catheterization is the anticoagulant drug delivery is more than one, it means that other factors are supporting the incidence of hematoma. Based on the results of this research will be done when the patient cardiac catheterization measures have gained anticoagulant therapy is more than one then it is a major factor in the catheterization team hematoma that offi cers remind each other of the factors that can be controlled so as not to increase the risk of hematoma CONCLUSIONS AND SUGGESTIONS Most of the patients who underwent catheterization via the radial action in space Hospital Cardiac Catheterization Dr. Sardjito sex male, mostly in the age group 55-59 years. Meanwhile, based on body mass index BMI of patients most patients the value of BMI 25 kg m2. prick with a frequency Exp B = 1.621. Based on the results of this study, there are fi ve variables: the type of drug administration, the size of the sheath, the value of blood pressure, puncture and TR Band frequency, the effect on the incidence of hematoma, while variables body mass index showed no effect on the incidence of hematoma. That the most dominant factor in the occurrence of hematoma on the action transradial cardiac catheterization is the anticoagulant drug delivery is more than one, it means that other factors are supporting the incidence of hematoma. SUGGESTION So prepared Standard Operating Procedure SOP Patient post Actions Cardiac Catheterization for monitoring complications incidence of hematoma after-action cardiac catheterization if there is a provision of anticoagulant drugs is more than one, use the size sheath large 6F, the value of patient’s blood pressure 140 mmHg, puncture performed more than once, the size of the TR Band pressure of less than 13 cc on the actions of cardiac catheterization. Corespondensi: Subroto, RSUP Dr. Sardjito Jln. Kesehatan Sekip No 1 Yogyakarta No. Hp : 08122726609, email : brotowaegmail.com