Hubungan tekanan darah sistolik saat admisi dengan tipe stroke pada pasien Instalasi Gawat Darurat (IGD) di RS swasta Jakarta Barat

Main Article Content

Joshua Kurniawan
Paskalis Andrew Gunawan

Abstract

Penyakit tidak menular merupakan salah satu masalah kesehatan yang dihadapi di seluruh dunia, termasuk penyakit serebrokardiovaskular, salah satunya adalah stroke. Stroke merupakan penyebab kematian tertinggi kedua di Indonesia dengan angka mortalitas mencapai 8,4% dari total kematian. Penelitian ini bertujuan untuk melihat apakah terdapat hubungan antara tekanan darah sistolik saat admisi dengan tipe stroke pada pasien Instalasi Gawat Darurat (IGD) di RS Swasta di Jakarta Barat. Studi ini bersifat analitik observasional dengan desain potong lintang. Pengambilan sampel dilakukan secara total sampling (n=94). Subyek studi adalah seluruh pasien yang menderita stroke yang masuk ke RS melalui IGD selama periode tahun 2019. Pengumpulan data dilakukan melalui rekam medis. Hasil analisis t-test independent menunjukkan hasil yang bermakna secara statistik antara tekanan darah sistolik saat admisi dengan tipe stroke pada pasien IGD di RS Swasta di Jakarta barat (p<0,001), dengan tekanan darah sistolik saat admisi yang lebih tinggi cenderung didapatkan pada pasien dengan stroke hemoragik dibandingkan stroke iskemik (SI vs SH: 152,18±2,77 mmHg vs. 186,82±30,79mmHg, CI 95%, min – max: 19,14 – 50,15 mmHg). Berdasarkan studi ini, tekanan darah sistolik saat admisi yang lebih tinggi cenderung mengarah ke stroke hemoragik sehingga dapat menjadi informasi tambahan untuk menyusun tatalaksana yang tepat.

Article Details

Section
Artikel Asli
Author Biography

Paskalis Andrew Gunawan, Fakultas Kedokteran Tarumanagara University

Internal Medicine Department of Tarumanagara University

References

Setiati S, Alwi I, Sudoyo AW, Simadibrata M, Setiyohadi B, Syam AF. Buku Ajar Ilmu Penyakit Dalam. Jilid II, Edisi VI. Jakarta: Balai Penerbit FKUI; 2014.

American Heart Association editor staff. Atherosclerosis [Inernet]. American Heart Association. 2019 [cited 2019 Sep 23]. Available from: https://www.heart.org/en/ health-topics/cholesterol/about-cholesterol/atherosclerosis

Hoffman C. Diagnostic test and procedure. In: Kamps BS, Hoffman C, Editors. COVID reference. Sixth Edition. Hamburg: Steinhauser Verlag; 2021. p. 303-32.

Lilly LS. Pathophysiology of Heart Disease - A Collaborative Project of Medical Students and Faculty. 6th Ed. London: Lippincott Williams & Wilkins, Wolters Kluwer; 2016. p.112-33.

World Health Organization (WHO). Disease burden and mortality estimates [Internet]. WHO. [cited 2019 Sep 17]. Available from: http://www.who.int/healthinfo /global_burden_disease/estimates/en/

Heart Disease and Stroke Prevention Division. Stroke Facts [Internet]. CDC. 2019 [cited 2019 Sep 23]. Available from: https://www.cdc.gov/stroke/facts.htm

World Health Organization (WHO). The world health report 2002 - Reducing Risks, Promoting Healthy Life [Internet]. WHO. 2002 [cited 2019 Sep 18]. Available from: https://www.who.int/whr/2002/en/

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation. March 2019;139 (10):e56-528.

Biro Komunikasi dan Pelayanan Masyarakat. Potret Sehat Indonesia dari Riskesdas 2018 [Internet]. Kementerian Kesehatan RI. 2018 [cited 2019 Sep 17]. Available from: https://www.kemkes.go.id/article/view/18110200003/potret-sehat-indonesia-dari-riskesdas-2018.html

World Health Organization (WHO). Indonesia: WHO Statistical Profile. WHO; 2012.

Guzik A, Bushnell C. Stroke Epidemiology and Risk Factor Management. Continuum (Minneap Minn). 2017 Feb;23(1):15–39.

Pistoia F, Sacco S, Degan D, Tiseo C, Ornello R, Carolei A. Hypertension and Stroke: Epidemiological Aspects and Clinical Evaluation. High Blood Press Cardiovasc Prev. 2016 Mar;23(1):9–18.

Grace M, Jacob K, Kumar A, K. S. Role of dyslipidemia in stroke and comparison of lipid profile in ischemic and hemorrhagic stroke -a case control study. Int J Adv Med. 2016;694–8.

World Health Organization (WHO). Hypertension [Internet]. 2019 [cited 2019 Sep 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension

Lawes CMM, Bennett DA, Feigin VL, Rodgers A. Blood Pressure and Stroke: An Overview of Published Reviews. Stroke. 2004 Mar;35(3):776–85.

Gaciong Z, Si?ski M, Lewandowski J. Blood Pressure Control and Primary Prevention of Stroke: Summary of the Recent Clinical Trial Data and Meta-Analyses. Curr Hypertens Rep. 2013 Dec;15(6):559–74.

Fischer U, Cooney MT, Bull LM, Silver LE, Chalmers J, Anderson CS, et al. Acute post-stroke blood pressure relative to premorbid levels in intracerebral haemorrhage versus major ischaemic stroke: a population-based study. Lancet Neurol. 2014 Apr;13(4):374-84.

Rianawati SB, Aurora H, Nugrahanitya Y. Correlation between blood pressure at admitted emergency room and clinically outcome in acute thrombotic stroke patients. Malang Neurol J. 2015 Jul ;1(2):51–8.

Badan Pusat Statistik. [cited 2020 Jun 4]. Available from: https://malangkota.bps. go.id/dynamictable/2019/05/15/19/jumlah-penduduk-di-kota-malang-menurut-kecamatan-dan-jenis-kelamin-2011-2020.html

Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011 Feb;42(2):517–84.

Kelly-Hayes M. Influence of Age and Health Behaviors on Stroke Risk: Lessons from Longitudinal Studies: Age, Health behaviours, and stroke. J Am Geriatr Soc. 2010 Oct;58:S325–8.

Koellhoffer EC, McCullough LD. The Effects of Estrogen in Ischemic Stroke. Transl Stroke Res. 2013 Aug;4(4):390–401.

Liu CH, Wei YC, Lin RJ, Chang CH, Chang TY, Huang KL, et al. Initial blood pressure is associated with stroke severity and is predictive of admission cost and one-year outcome in different stroke subtypes: a SRICHS registry study. BMC Neurol. 2016 Dec;16(1):[8p.]

Wajngarten M, Silva GS. Hypertension and Stroke: Update on Treatment. Eur Cardiol Rev. 2019 Jul;14(2):111–5.

Carlberg B, Asplund K, Hägg E. Factors influencing admission blood pressure levels in patients with acute stroke. Stroke. 1991 Apr;22(4):527–30.

Pezzini A, Grassi M, Del Zotto E, Volonghi I, Giossi A, Costa P, et al. Influence of acute blood pressure on short- and mid-term outcome of ischemic and hemorrhagic stroke. J Neurol. 2011 Apr;258(4):634–40.

Vemmos KN, Tsivgoulis G, Spengos K, Zakopoulos N, Synetos A, Manios E, et al. U-shaped relationship between mortality and admission blood pressure in patients with acute stroke. J Intern Med. 2004 Feb;255(2):257–65.

Koton S, Eizenberg Y, Tanne D, Grossman E. Trends in admission blood pressure and stroke outcome in patients with acute stroke and transient ischemic attack in a National Acute Stroke registry. J Hypertension. 2016 Feb;34(2):316–2