Hubungan Kadar D-dimer Saat Awal Pemeriksaan Pada Pasien Pneumonia Komunitas Terhadap Kematian 30 Hari
Abstrak
“ Hubungan Kadar D-dimer Saat Awal Pemeriksaan Pada Pasien
Pneumonia Komunitas Terhadap Kematian 30 Hari ”
Fahmi, 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 yang lebih baik sehingga angka kematian 30
hari pada PK dapat dikurangi. D-dimer (DD) dikenal sebagai biomarker koagulasi
yang berguna dalam menilai derajat keparahan PK. DD dapat berperan dalam
prognosis penderita PK.
Tujuan :
Untuk mengetahui hubungan kadar D-dimer pada saat awal pemeriksaan pasien
pneumonia komunitas terhadap kematian 30 hari.
Bahan dan Cara :
Penelitian dilakukan secara cohort study yang bersifat prospektif. Subjek dengan
pneumonia komunitas yang masuk dari instalasi gawat darurat, setelah memenuhi
kriteria dilakukan penilaian skor CURB-65(Confusion, Urea, Respiratory rate,
Blood pressure, Age >65 years), DD, laboratorium darah, kultur sputum dan
darah. Selanjutnya skor CURB-65 dihubungan dengan DD dan kematian 30 hari.
Hasil :
Dari 57 subjek penelitian dimana yang meninggal sebanyak 17 subjek (36,2%)
yang tergolong dalam skor CURB-65 berat memiliki kadar DD > 500 μg/ L, dan
sebanyak 3 subjek (6,4%) yang tergolong dalam skor CURB-65 ringan-sedang
memiliki kadar kadar DD < 500 μg/ L. Setelah dilakukan chi-Square test
diperoleh hubungan signifikan antara peningkatan kadar DD dengan kematian 30
hari (p= 0,0001)
Kesimpulan :
Kadar D-dimer diawal pemeriksaan pada penderita pneumonia komunitas
berkorelasi kuat dengan jumlah kematian 30 hari, dimana semakin tinggi tinggi
kadar D-dimer maka semakin tinggi jumlah kematian 30 hari.
Kata Kunci : pneumonia komunitas, skor CURB-65, D-dimer, kematian 30 hari.
vi
Universitas Sumatera Utara
Abstract
Levels of D-dimer relationship Preliminary Examination In Patients At
Community Against Pneumonia 30-Day Mortality
Fahmi, E.N. Keliat, Alwinsyah Abidin,
Pulmonology and Allergy-Immunology
Internal Medicine Department Division
Faculty of Medicine University of Sumatera Utara
H. Adam Malik General Hospital Medan
Background
Pneumonia in patients with community, to assess the degree of severity in the
early admission is crucial because it will determine the severity of the disease and
subsequent treatment of the plan better so that 30-day mortality rate can be
reduced on the PK. D-dimer (DD) is known as coagulation biomarkers are useful
in assessing the degree of severity of community acquired pneumonia (CAP) . DD
can play a role in the prognosis of patients with community acquired pneumonia
(CAP).
Objective :
To determine the relationship of D-dimer levels at initial examination of
community pneumonia patients to death 30 days.
Materials and Methods :
Research conducted a prospective cohort study. Subjects with CAP coming from
the emergency department, after meeting the assessment criteria CURB-65 score
(Confusion, Urea, Respiratory rate, Blood pressure, Age > 65 years), DD,
laboratory blood, sputum and blood cultures. We had correlate the DD levels with
CURB-65 to 30-day mortality.
Result :
Of the 57 subjects in which the dead were 17 subjects (36.2%) were classified in
the CURB-65 score has a weight of DD levels > 500 μg/L, and as many as 3
subjects (6.4%) were classified in the CURB-65 score had mild-moderate levels
of DD levels < 500 μg/L. After the chi-square test obtained a significant
relationship between elevated levels of DD with 30-day mortality (p = 0.0001)
Conclusion :
D-dimer levels in patients with pneumonia early inspection is strongly correlated
with the number of community deaths 30 days, where the higher the higher levels
of D-dimer, the higher number of deaths 30 days.
Key Word : community acquired pneumonia, CURB-65 score, D-dimer,
30-day mortality.
vii
Universitas Sumatera Utara
“ Hubungan Kadar D-dimer Saat Awal Pemeriksaan Pada Pasien
Pneumonia Komunitas Terhadap Kematian 30 Hari ”
Fahmi, 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 yang lebih baik sehingga angka kematian 30
hari pada PK dapat dikurangi. D-dimer (DD) dikenal sebagai biomarker koagulasi
yang berguna dalam menilai derajat keparahan PK. DD dapat berperan dalam
prognosis penderita PK.
Tujuan :
Untuk mengetahui hubungan kadar D-dimer pada saat awal pemeriksaan pasien
pneumonia komunitas terhadap kematian 30 hari.
Bahan dan Cara :
Penelitian dilakukan secara cohort study yang bersifat prospektif. Subjek dengan
pneumonia komunitas yang masuk dari instalasi gawat darurat, setelah memenuhi
kriteria dilakukan penilaian skor CURB-65(Confusion, Urea, Respiratory rate,
Blood pressure, Age >65 years), DD, laboratorium darah, kultur sputum dan
darah. Selanjutnya skor CURB-65 dihubungan dengan DD dan kematian 30 hari.
Hasil :
Dari 57 subjek penelitian dimana yang meninggal sebanyak 17 subjek (36,2%)
yang tergolong dalam skor CURB-65 berat memiliki kadar DD > 500 μg/ L, dan
sebanyak 3 subjek (6,4%) yang tergolong dalam skor CURB-65 ringan-sedang
memiliki kadar kadar DD < 500 μg/ L. Setelah dilakukan chi-Square test
diperoleh hubungan signifikan antara peningkatan kadar DD dengan kematian 30
hari (p= 0,0001)
Kesimpulan :
Kadar D-dimer diawal pemeriksaan pada penderita pneumonia komunitas
berkorelasi kuat dengan jumlah kematian 30 hari, dimana semakin tinggi tinggi
kadar D-dimer maka semakin tinggi jumlah kematian 30 hari.
Kata Kunci : pneumonia komunitas, skor CURB-65, D-dimer, kematian 30 hari.
vi
Universitas Sumatera Utara
Abstract
Levels of D-dimer relationship Preliminary Examination In Patients At
Community Against Pneumonia 30-Day Mortality
Fahmi, E.N. Keliat, Alwinsyah Abidin,
Pulmonology and Allergy-Immunology
Internal Medicine Department Division
Faculty of Medicine University of Sumatera Utara
H. Adam Malik General Hospital Medan
Background
Pneumonia in patients with community, to assess the degree of severity in the
early admission is crucial because it will determine the severity of the disease and
subsequent treatment of the plan better so that 30-day mortality rate can be
reduced on the PK. D-dimer (DD) is known as coagulation biomarkers are useful
in assessing the degree of severity of community acquired pneumonia (CAP) . DD
can play a role in the prognosis of patients with community acquired pneumonia
(CAP).
Objective :
To determine the relationship of D-dimer levels at initial examination of
community pneumonia patients to death 30 days.
Materials and Methods :
Research conducted a prospective cohort study. Subjects with CAP coming from
the emergency department, after meeting the assessment criteria CURB-65 score
(Confusion, Urea, Respiratory rate, Blood pressure, Age > 65 years), DD,
laboratory blood, sputum and blood cultures. We had correlate the DD levels with
CURB-65 to 30-day mortality.
Result :
Of the 57 subjects in which the dead were 17 subjects (36.2%) were classified in
the CURB-65 score has a weight of DD levels > 500 μg/L, and as many as 3
subjects (6.4%) were classified in the CURB-65 score had mild-moderate levels
of DD levels < 500 μg/L. After the chi-square test obtained a significant
relationship between elevated levels of DD with 30-day mortality (p = 0.0001)
Conclusion :
D-dimer levels in patients with pneumonia early inspection is strongly correlated
with the number of community deaths 30 days, where the higher the higher levels
of D-dimer, the higher number of deaths 30 days.
Key Word : community acquired pneumonia, CURB-65 score, D-dimer,
30-day mortality.
vii
Universitas Sumatera Utara