ANALISIS FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN NILAI REVISED TRAUMA SCORE DALAM MEMPREDIKSI MORTALITY PASIEN CIDERA KEPALA BERAT DI RSD MARDI WALUYO BLITAR

Ika Rahmawati, M. Hidayat, Yulian Wiji Utami

Abstract


ABSTRAK
Cidera kepala memiliki angka kejadian, kematian, dan kecacatan yang tinggi. Penilaian kondisi awal pasien dapat dilakukan dengan Revised Trauma Score (RTS), meliputi Glasgow Coma Scale (GCS), sistolik, dan frekuensi pernafasan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berpengaruh pada RTS dalam memprediksi Mortality pasien cidera kepala berat di RSD Mardi Waluyo Blitar. Penelitian ini bersifat observasional analitik dengan purposive sampling (N 42). Faktor yang diteliti meliputi usia, jenis kelamin, trauma organ lain, suhu tubuh, kadar glukosa darah, tekanan darah, GCS, dan Respiratory Rate (RR). Hasil uji spearman rho menunjukkan bahwa trauma organ lain, suhu tubuh, tekanan darah, GCS, dan RR berhubungan dengan nilai RTS. Sementara itu, hasil uji spearman rho menunjukkan bahwa ada hubungan antara nilai RTS dengan Mortality pasien cidera kepala berat (p 0,000). Dengan demikian dapat disimpulkan bahwa trauma organ lain, suhu tubuh, glukosa darah, tekanan darah, GCS, dan RR dapat digunakan sebagai prediktor nilai RTS. Sementara itu nilai RTS dapat memprediksi mortality pasien cidera kepala berat.

Kata-kata kunci : revised trauma score, mortalitas, cidera Kepala.

 

ABSTRACT
Recently, head injury
have high prevalence, death, and disability. RTS eventualy used for initial assesment including GCS score, systole, and respiration frequency. Aim of this study were analyzed factors influencing RTS score to predict mortality in head injury patients in RSD Mardi Waluyo Blitar.  This study used observational analytic with purposive sampling (N 42). Factors studied consist of age, sex, trauma on other organ, temperature, blood glucose, blood pressure, GCS, and Respiratory rate. The result of spearman rho show that trauma on other organ, temperature, blood pressure, GCS, and Respiratory Rate related to RTS. Positively, The spearman rho show relationship between RTS and mortality of severe head injury patients (p : 0, 000). Conclusion: other organ trauma, temperature, blood glucose, blood pressure, GCS, and Respiratory Rate can be used as predictor of RTS and RTS can predict mortality of severe head injury patients.

Keywords : revised trauma score, mortality, head injury.


Full Text:

PDF

References


KEPUSTAKAAN

Faul, M., xu, L., wald, M.M., Coronado, V.G. 2010. Traumatic Brain Injury Emergency Department Visits, Hospitalizations and Deaths 20022006. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

Edna, T.H. 1983. Risk factors in traumatic head injury. Acta Neurochir; 69: 15-21.

Retnaningsih. 2008. Cedera kepela traumatic. www.kabarindonesia.com Diakse tanggal 16 Januari 2013.

Tobing HG. 2011. Sinopsis ilmu bedah saraf Departemen Bedah Saraf FKUI-RSCM. Jakarta: Agung Seto.

Signorini DF, Andrews PJ, Jones PA,et al. 1999. Predicting survival using simple clinical case study in traumatic brain injury. J Neuoral Neurosurg Psychiatry; 60: 20-25.

Hawley C. 2010. Management of minor head injury in adults. Emergency Nurse. Health Sciences Research Institute, Warwick Medical School, University of Warwick.

Bisri T. 2012. Penanganan neuroanestesia dan critical care cedera otak traumatik 3th ed. Bandung : Saga Olahcitra.

Harrison-Felix CL, Whiteneck GG, Jha A, DeVivo MJ, Hammond FM, Hart DM. 2009. Mortality over four decades after traumatic brain injury rehabilitation: a retrospective cohort study. Arch Phys Med Rehabil; 90: 1506-13.

Vogelzhang M, Nijboer JMM, Horst ICC, Zijlstra F, Duis HT, Nijsten MWN. 2006. Hyperglikemia has a stronger relation with outcome in trauma patients than in other crtically ill patients. J trauma; 60(4): 873-7.

Rao V, Lyketsos C. 2000. Neuropsychiatric sequelae of traumatic brain injury. Psychosomatic; 41: 95-103.

Bullock MR, Povlishock. Guidelines for the management of severe traumatic brain injury. Journal Neurotrauma, 2007; 24.

Newfield P, Pitts KH, Kaktis J, et al. The influence of shock on mortality after head injury. Crit Care Med, 1980; 8: 254-5

Rayvita. 2010. Mean arterial pressure postresusitasi sebagai prediktor keluaran pasien cedera otak traumatik berat dengan gambaran Ct cedera difus. Undergraduate thesis, Faculty of Medicine.

Becker DP, Miller JD, Ward JD, et al. The outcome from severe head injury with early diagnosis and intensive management. Jneurosurg, 1997; 47: 491-502.

Jennet, Bryan. 2005. Development of glasgow coma and outcome scales. Nepal Journal of Neuroscience, 2005; 2: 24-28.

Kesuma AD, Bangun K. Evaluation of facial trauma severity in Cipto Mangunkusumo Hospital using FISS scoring system. Jurnal Plastik Rekonstruksi, 2012; 2: 162-165.

Sastrodiningrat AG. 2006. Memahami faktor-faktor yang mempengaruhi prognosa cedera kepala berat. Majalah Kedokteran Nusantara Vol.39 No.3.

Choi SC, Ward JD, Becker DP. Chart for outcome prediction in severe head injury. Jneurosurg, 1983; 59: 294-297.

Lunn KW, Childs C. 2010. A systematic review of differences between brain temperature in adult patients with severe traumatic brain injury. Singapore National University Hospital (NUH) Centre for evidence based Nursing: a collaborating centre of the Joannna Briggs Institute.

Thompson HJ, Hoover RC, Tkacs NC, Saatman KE, McIntosh TK. Development of post traumatic hyperthermia after traumatic brain injury in rats is associated with increased periventricular inflammation. Journal of cerebral blood flow & metabolism, 2005; 25: 163-176.

Aritonang S. 2007. Correlation between blood glucose level with outcome of moderate and severe closed head injury with brain CT scan normally. Semarang: Universitas Diponegoro Akbar.

Newberry, Criddle. 2000. Trauma nursing care course Ed.5. Des Plaines, III. The Association.

Rose J, Valtonen S, Jennett B. Avoidable factors contributing to death after head injury. Brit Med, 1977; 2: 615-8.

Miller JD, Butterworth JF, Gudeman SK, et al. Further experience in the management of severe head injury. Jneurosurg, 1981; 54: 289-299.

Senkowski CK, Mc Kenney MG. Trauma scoring system: a review. J Am Coll Surg, 1999; 30: 540.

Yulius T. Gangguan asam-basa karena hipernatremia pada cedera kepala. Anestesia &Critical Care, 2010; 28 (3).

Oertel M, Kelly DF, Lee JH, McArthur DL, Glenn TC, Vespa P, et al. Efficacy of hyperventilation, blood pressure elevation and metabolic suppression therapy in controlling intracranial pressure after head injury. Jneurosurg, 2002; 97: 1045-53.

Irawan H, Setiawan F, Dewi, Dewanto G. 2010. Perbandingan Glasgow Coma scale dan revised trauma score dalam memprediksi disabilitas pasien trauma kepala di rumah sakit Atma Jaya. Maj Kedokt Indon, Vol.60 No.10.

Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised trauma scoring system to predict in hospital mortality in the emergency deprtment: glasgow coma scale, age, and systolic cblood pressure score. Critical Care, 2011; 15:R191.

Madikians A, Giza C. A clinician’s guide to the pathophysiology of traumatic brain injury. Indian Journal of Neurotrauma (IJNT), 2006; 3 (1): 9-17.

Stiver SI, Gean AD, Manley GT. Survival with good outcome after cerebral herniation and duret hemorrhage caused by traumatic brain injury. Jneur, 2009.




DOI: http://dx.doi.org/10.20527/dk.v1i2.3175

Article Metrics

Abstract view : 1173 times
PDF - 625 times

Refbacks

  • There are currently no refbacks.


Indexed by :

  

   

 

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

freehit counter

View Dunia Keperawatan Stats