GAMBARAN DAN KARAKTERISTIK PASIEN DELIRIUM PADA CEDERA OTAK DI RUMAH SAKIT UMUM DAERAH PROVINSI NUSA TENGGARA BARAT
DOI:
https://doi.org/10.29303/jku.v9i4.442Kata Kunci:
cedera otak, TBI, delirium, jenis kelamin, usia, letak lesi, kadar leukosit, kadar glukosaAbstrak
Latar Belakang: Cedera otak merupakan kejadian trauma yang mengenai otak dan menyebabkan kerusakan baik secara struktur maupun fungsi. Tingginya angka kejadian cedera otak baik di dunia maupun di Indonesia mayoritas diakibatkan oleh kecelakaan lalu lintas kendaraan bermotor. Adanya kerusakan tersebut menyebabkan munculnya sekuele psikiatri dan salah satunya adalah delirium.
Metode: Penelitian ini merupakan observasional deskriptif dengan pendekatan cross-sectional. Pengambilan data dilakukan di RSUDP NTB dengan metode nonprobability sampling yaitu consecutive sampling. Cara pengambilan data yaitu secara langsung pada 39 orang pasien cedera otak rawat inap di RSUDP NTB. Peneliti melakukan observasi langsung kepada pasien dan mengkaji rekam medis pasien.
Hasil: Dari 39 sampel pasien cedera otak, didapatkan 32 orang (82,05%) mengalami delirium, dengan dominasi pria sebanyak 24 orang (61,54%) mengalami delirium. Berdasarkan derajat keparahannya, didapatkan cedera otak sedang (COS) terbanyak diantara derajat lainnya. Dari hasil CT Scan pasien dengan delirium, kebanyakan pasien memiliki lesi diffuse. Selain itu, hasil laboratorium terhadap kadar leukosit didapatkan meningkat pada pasien delirium, sedangkan kadar glukosa mayoritas pasien dalam batas normal.
Kesimpulan: Pasien dengan delirium pada TBI didominasi oleh pria terutama kelompok usia 51-65 tahun. Selain itu, letak lesi yang diffuse, peningkatan kadar leukosit, dan kadar glukosa yang normal sering didapatkan pada pasien delirium pada TBI.
Kata kunci: cedera otak, TBI, delirium, jenis kelamin, usia, letak lesi, kadar leukosit, kadar glukosa
Referensi
2. World Health Organization. Global Status Report on Road. World Heal Organ. 2018;20.
3. Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2019;130(4):1080–97.
4. World Health Organization. Violence and Injury Prevention: Indonesia. 2015 [cited 2019 Sep 29]; Available from: https://www.who.int/violence_injury_prevention/road_safety_status/2015/country_profiles/Indonesia.pdf?ua=1
5. Putri D, Fitria CN. Ketepatan dan Kecepatan Terhadap Life Saving Pasien Trauma Kepala. STIKES PKU Muhammadyiyah Surakarta. 2018;846–55.
6. Rosyidi RM, Priyanto B, Laraswati NKP, Islam AA, Hatta M, Bukhari A, et al. Characteristics and clinical outcome of traumatic brain injury in Lombok, Indonesia. Interdiscip Neurosurg Adv Tech Case Manag [Internet]. 2019;18(February):100470. Available from: https://doi.org/10.1016/j.inat.2019.04.015
7. Manshouriyatham J, Schmidt B. Archives of Neurology & Neurological Disorders. 2019;2(1):2–4.
8. Sudarsanan S, Chaudhary S, Pawar AA, Srivastava K. Psychiatric effects of traumatic brain injury. Med J Armed Forces India. 2007;63(3):259–63.
9. Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: diagnosis, prevention and treatment [Internet]. 2009 [cited 2019 Oct 31]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/
10. Saifullah AD, Chen C-M. Early Delirium Assessment for Hospitalized Older People in Indonesia: A Systematic Review. Nurse Media J Nurs. 2016;6(1):9–18.
11. Maneewong J, Maneeton B, Maneeton N, Vaniyapong T, Traisathit P, Sricharoen N, et al. Delirium after a traumatic brain injury: Predictors and symptom patterns. Neuropsychiatr Dis Treat. 2017;13:459–65.
12. Munivenkatappa A, Agrawal A, Shukla D, Kumaraswamy D, Devi B. Traumatic brain injury: Does gender influence outcomes? Int J Crit Illn Inj Sci [Internet]. 2016 Apr 1 [cited 2020 Oct 25];6(2):70. Available from: http://www.ijciis.org/text.asp?2016/6/2/70/183024
13. Jang S, Jung KI, Yoo WK, Jung MH, Ohn SH. Risk factors for delirium during acute and subacute stages of various disorders in patients admitted to rehabilitation units. Ann Rehabil Med [Internet]. 2016 [cited 2020 Oct 25];40(6):1082–91. Available from: /pmc/articles/PMC5256313/?report=abstract
14. Thompson HJ, McCormick WC, Kagan SH. Traumatic brain injury in older adults: Epidemiology, outcomes, and future implications [Internet]. Vol. 54, Journal of the American Geriatrics Society. NIH Public Access; 2006 [cited 2020 Oct 25]. p. 1590–5. Available from: /pmc/articles/PMC2367127/?report=abstract
15. Venturini S, Still MEH, Vycheth I, Nang S, Vuthy D, Park KB. The National Motorcycle Helmet Law at 2 Years: Review of Its Impact on the Epidemiology of Traumatic Brain Injury in a Major Government Hospital in Cambodia. World Neurosurg [Internet]. 2019;125:320–6. Available from: https://doi.org/10.1016/j.wneu.2019.01.255
16. Rosyidi RM, Priyanto B, Al Fauzi A, Sutiono AB. Toward zero mortality in acute epidural hematoma: A review in 268 cases problems and challenges in the developing country. Interdiscip Neurosurg Adv Tech Case Manag [Internet]. 2019;17(November 2018):12–8. Available from: https://doi.org/10.1016/j.inat.2019.01.021
17. Bhalerao SU, Geurtjens C, Thomas GR, Kitamura CR, Zhou C, Marlborough M. Understanding the neuropsychiatric consequences associated with significant traumatic brain injury [Internet]. Vol. 27, Brain Injury. Informa Healthcare; 2013 [cited 2020 Oct 23]. p. 767–74. Available from: http://www.tandfonline.com/doi/full/10.3109/02699052.2013.793396
18. Rovlias A, Kotsou S. The blood leukocyte count and its prognostic significance in severe head injury. Surg Neurol [Internet]. 2001 Apr [cited 2020 Oct 25];55(4):190–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0090301901004141
19. Al -Gahtany M. Original Article Serum Leukocyte Count (WBC) Levels as an Indicator for Severity of Traumatic Brain Injury in Saudi Arabia Patients. Vol. 30, Egyptian Journal of Neurosurgery. 2015.
20. Zhao Y, Yue J, Lin T, Peng X, Xie D. Neutrophil-lymphocyte ratio as a predictor of delirium in older hospitalized patients?: a prospective cohort study. 2019;
21. Viderman D, Brotfain E, Bilotta F, Zhumadilov A. Risk Factors and Mechanisms of Postoperative Delirium After Intracranial Neurosurgical Procedures | AJA Asian Journal of Anesthesiology [Internet]. 2020 [cited 2020 Oct 24]. Available from: http://www.aja.org.tw/articles/content.php?id=224&flag=1
22. Rovlias A, Kotsou S. The influence of hyperglycemia on neurological outcome in patients with severe head injury. Neurosurgery [Internet]. 2000 Feb 1 [cited 2020 Oct 24];46(2):335–43. Available from: https://academic.oup.com/neurosurgery/article/46/2/335/2931453
23. Shi J, Dong B, Mao Y, Guan W, Cao J, Zhu R, et al. Review: Traumatic brain injury and hyperglycemia, a potentially modifiable risk factor. Oncotarget. 2016;7(43):71052–61.
