Jurnal Neuroanestesi Indonesia (Feb 2017)

Korelasi antara Nilai S100-Beta Pre dan Post Kraniotomi Evakuasi Perdarahan Intraserebral Spontan dengan Luaran

  • Achmad Adam,
  • Bilzardy Ferry,
  • Dhira Atman

DOI
https://doi.org/10.24244/jni.vol6i1.36
Journal volume & issue
Vol. 6, no. 1
pp. 8 – 14

Abstract

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Latar Belakang dan Tujuan: Perdarahan intraserebral/Intracerebral hemorrhage (ICH) spontan ialah penyakit luaran bervariasi yang cenderung fatal dan berbiaya tinggi. S100B ialah enzim yang dapat dinilai pada serum darah saat sel otak cedera dengan biaya lebih rendah dibanding CT-Scan kepala. Penelitian ini mencari korelasi S100B dengan luaran ICH spontan. Prediksi dini luaran buruk pada masa perawatan postoperatif akan mempermudah tenaga medis dan keluarga memutuskan terapi lebih lanjut. Subjek dan Metode: Penelitian cross sectional ini mencari korelasi dengan pengumpulan data prospektif consecutive sampling pada 40 pasien ICH spontan yang dilakukan kraniotomi evakuasi di bagian bedah saraf RSUP Hasan Sadikin Bandung periode Januari–Juli 2016. Hasil: Pasien ICH spontan menunjukkan korelasi positif signifikan S100B preoperatif dan postoperatif dengan mortalitas. Risiko relatif ICH spontan dengan S100B preoperatif 0,220 ug/L berpeluang meninggal 3,157 kali lebih besar dan S100B postoperatif 0,225 ug/L berpeluang meninggal 5,405 kali. Ada korelasi negatif signifikan antara S100B preoperatif dan postoperatif dengan Glasgow Outcome Score (GOS). Ada korelasi positif signifikan antara S100B preoperatif dan postoperatif dengan volume ICH. Tidak ada perbedaan signifikan antara nilai S100B preoperatif dan postoperatif. Simpulan: Nilai serum S100B pre dan post kraniotomi evakuasi ICH spontan berkorelasi dengan luaran mortalitas dan GOS. Nilai S100B postoperatif 0,225 ug/L dapat membantu memutuskan terapi lanjut post kraniotomi. The Correlation between S-100 Beta Level at Pre and Post Craniotomy Evacuation Spontaneous Intracerebral Hemorrhage with Outcome Background and Objective: Spontaneous intracerebral hemorrhage (ICH) is a disease with diverse outcome which tends to be fatal and costly. S100B is a measurable enzyme from the blood serum when astrocytes are damaged. S100B has less cost compared with head CT-Scan. This study used S100B to predict spontaneous ICH outcome. Early post operative prediction of poor outcome would help in deciding further therapy. Subject and Method: This is a cross sectional study to find a correlation between variables by collecting prospective data with consecutive sampling of 40 inpatient spontaneous ICH subjects and performed craniotomy evacuation at Hasan Sadikin hospital neurosurgery department during January-July 2016 period. Result: Spontaneous ICH patients demonstrated significant positive correlation between preoperative and postoperative S100B levels with mortality. Relative risk of spontaneous ICH with 0.220 ug/L preoperative S100B level had 3.157 higher death risk and 0.225 ug/L postoperative S100B level had 5.405 higher death risk. There was significant negative correlation between preoperative and postoperative S100B levels with ICH volume. There was no significant difference between preoperative and postoperative S100B levels. Conclusion: S100B serum levels of pre and post craniotomy evacuation of spontaneous ICH patients had correlations between mortality and GOS outcome. Postoperative S100B level 0.225 can deciding further therapy.

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